Overview of Treatment Options in Relapsed/Refractory Multiple Myeloma
Opening the panel’s discussion on multiple myeloma management, Rafael Fonseca, MD, reviews treatment options available to patients at early or late relapse.
Transcript:
Rafael Fonseca, MD: Welcome to this Cancer Network Training Academy session entitled “Institutional Perspectives From Mayo Clinic: Implementing Treatment With Bispecifics in Clinical Practice”. I am your host, Rafael Fonseca. I am a professor of medicine in the division of hematology and medical oncology, and the chief innovation officer at Mayo Clinic in Arizona. I have a great panel of experts who have joined me today. I would like to invite my esteemed fellow panelists to introduce themselves, and we'll start with you, Dr Kumar.
Shaji Kumar, MD: Thank you, Rafael. My name is Shaji Kumar. I'm a hematologist at Mayo Clinic in Rochester, Minnesota.
Rafael Fonseca, MD: Thank you very much. Dr Cook.
Joselle Cook, MBBS: I am Joselle Cook. I'm also a hematologist with the group here at Mayo Clinic in Rochester.
Rafael Fonseca, MD: And Dr Gertz.
Morie Gertz, MD: I'm a consultant in the division of hematology, and I work in the myeloma dysproteinemia clinic in Rochester, Minnesota.
Rafael Fonseca, MD: Thank you all. It's a pleasure to have you here today, and thank you also for the audience joining us. As I mentioned today, we're going to discuss how we incorporate bispecific antibodies into the treatment of patients with relapsing multiple myeloma. We will discuss specifics on how the health care teams at Mayo Clinic have implemented step-up dosing, transition of care, full treatment doses, as well as some general recommendations and truly a conversation about the best clinical practice for use of bispecific antibodies. Now, before we get into that, I'll just briefly discuss the current status of the treatment for multiple myeloma. We are very fortunate that we have seen over 20 FDA approvals for various medications, alone or in combination for the treatment of the disease. And we clearly see an improvement in the overall survival for patients who are diagnosed with multiple myeloma. Conceptually at the moment, we're thinking about those treatment options that are available for early relapse, and we've seen a number of combinations, particularly carfilzomib in combination with anti-CD38 antibodies. Also, we have seen pomalidomide-based regimens. But the reality is most of these patients ultimately experience a relapse. And at that point, we now have a range of options, but among those options, the ones that are of the highest interests at the moment are the use of CAR [chimeric antigen receptor] T cells as well as bispecific antibodies. We're very fortunate that we have 2 CAR T-cell products that have been approved for the treatment of these patients. And now we have 1 bispecific antibody that's available in our armamentarium. But there's lots of questions about best use, selection of patients, timing, and supportive aspects; and we will try to cover some of that, particularly with a focus on bispecifics, today.
Transcript edited for clarity.
