RELAPSED/REFRACTORY MULTIPLE MYELOMA PATIENTS

Chairmen: Joan Bladé, Sundar Jagannath 

How I treat Relapsed/Refractory Multiple Myeloma, Sequence Strategy, Patient Selection

Robert Orlowski

Common themes:

-       Does patient need treatment?

-       If yes, are they fit or frail (2 drugs)?

-       Should salvage be aggressive (3 drugs)?

-       Can I reuse a combo that worked before?

-       Do I need to change the MOA of the drugs?

-       How many new/novel drugs can I introduce?

-       What toxicities may be an issue for this patient?

SLIDES

How I treat Refractory Disease and Extramedullary Disease

Joan Bladé

General considerations:

1. EMD in MM treatment

- Efficacy of alkylating agents and radiation therapy

- Efficacy of Bortezomib

- Limited efficacy of IMIDs

- Potential dissociation between medullary and extramedullary response

2. Treatment of refractory MM

- Doubtful clinical benefit of “stable disease” in clinical trials unless that evident PD is controlled

- Comparator arm in clinical trials: best supportive care with Cyclo/Predni

- Synergistic/additive effect in drug combinations

- clinical judgement: when to offer only palliative care

SLIDES

How I treat Serious Adverse Events

Heinz Ludwig 

Conclusions and future perspectives

Prevention and treatment of adverse events is of key importance in the management of patients with MM.

-       Reduces the need for treatment discontinuation

-       Enhances the efficacy of treatment

-       Reduces the need for hospitalization

-       Reduces mortality

SLIDES