Treatment Options for Frontline and Relapsed Multiple Myeloma
An overview of multiple myeloma treatment options in the frontline and relapsed settings.
Transcript:
Ola Landgren, MD, PhD: Many different treatments are approved. We have carfilzomib-based [treatments], we have pomalidomide-based [treatments], and we have other combinations. I mentioned there are over 40 approved combinations in the NCCN [National Comprehensive Cancer Network] guidelines. Is it better to use daratumumab in the front line or could that be done in the relapse setting? Or could you do both?
Dickran Kazandjian, MD: That’s a difficult question, Ola. I think we still have studies that are somewhat investigating that. It’s very difficult not only because we don’t have the…randomized study to show or compare the difference, [but] I think every person is different. There’s a subset of patients that do benefit from up-front anti-CD38 monoclonal antibodies, but I don’t think every patient benefits from it. But how do you tease out those who don’t need it? You don’t. You [must] treat the larger group for the larger good.
Eventually, if time tells the same story in drug development, there’s always this question, do you use the better drug as a second line to increase the total duration that a patient can benefit from it? Do you give it sort of up front for the maximal impact? These are always questions and really can’t be answered without randomized studies, which are very difficult to conduct with the long overall survivals that we have in multiple myeloma [MM], which is a good thing. But time always tells. It seems like getting the newer, better drug up front is always better because there is a small fraction of patients that probably can’t wait to get it second line.
Ola Landgren, MD, PhD: Thank you.
Transcript edited for clarity.
