Examining Changes in the Multiple Myeloma Treatment Landscape

Jeffrey R. Schriber, MD, FRCP, director of Hematologic Malignancies, City of Hope Atlanta, Chicago, and Phoenix, discusses some of the available treatment options for patients with multiple myeloma and how the treatment landscape has evolved over time.

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0:08 | It continues to evolve, and myeloma is probably the most exciting field to be in just because we continue to see things change over time. We have a pretty good sense for what we should start with, but even there is a debate whether you give a triplet [regimen] or do 4 drugs up front.

0:26 | Most of us are still leaning towards a transplant, but now, there are a lot of questions [in the space]. Should you do transplant early vs late? And then when patients relapse, the question is, what should you do? And I think earlier and earlier, what we are seeing is the incorporation of different therapies that we have got available. Everyone is very excited about CAR [chimeric antigen receptor] T-cells, but CAR T-cells take time to process and sometimes there are issues with this, but the BiTE cells, I think, are very exciting. And what we are seeing now is the combination of BiTE cells with other therapies, which I suspect will be where we will go in the future.

1:03 | Transplant, to my mind, remains a major importance, but we have now got a randomized trial that shows it doesn't improve overall survival, but PFS [progression-free survival] is close to 2 years better, suggesting that [transplant] still maintains its important efficacy [and role in treatment]. Moreover, we are now seeing data that shows we can use this in older patients and, of course, with a [patient population that has a] median age of 70, we need to be doing this in patients that are over 70.