Iberdomide-Based Treatment in Lenalidomide-Refractory Multiple Myeloma

The discussion continues with the first clinical scenario involving lenalidomide-refractory multiple myeloma. Dr. Mikhael asks Dr. Goldsmith how he would approach a patient with biochemical progression on lenalidomide maintenance who remains daratumumab-exposed but not daratumumab-refractory. Dr. Goldsmith discusses the preclinical, translational, and clinical evidence supporting an iberdomide-based combination in this setting, including the potential for meaningful responses and deeper disease control. The panel also considers the tolerability profile of iberdomide relative to established IMiDs, with Dr. Mikhael noting differences in commonly encountered adverse effects such as fatigue, diarrhea, and muscle cramping. The conversation emphasizes the importance of considering both disease characteristics and treatment tolerability when selecting therapy for multiple myeloma, while recognizing the expanding range of available treatment options.