Exploring How to Get the Best Response in Frontline Multiple Myeloma

Caitlin Costello, MD, a hematologist/medical oncologist and assistant professor of medicine at the University of California, San Diego ​Health, discusses choosing the optimal first-line therapy for patients with multiple myeloma.

The goal of induction therapy in the first line for these patients is to remove as much of the disease as possible. Costello says that ideally this would mean getting the patient to at least a complete remission, if not a stringent complete remission. How to approach getting patients with standard-risk or high-risk disease to these responses is what Costello thinks should be the main focus in this setting. That may mean taking different approaches to reach the same goal.

If a patient has multiple myeloma that is highly proliferative or highly aggressive, they would probably need a more aggressive therapy to get the best response, according to Costello. However, she says this isn’t definitive yet, so multiple clinical trials for patients who are newly diagnosed are looking at which regimens are appropriate for standard-risk disease versus which regimens are best for high-risk disease.