Multiple Myeloma 2021 - Episode 10

Optimal Therapies for Relapsed/Refractory Multiple Myeloma

Nina Shah, MD, details the process to choose optimal therapeutic options for patients with relapsed/refractory multiple myeloma.

Nina Shah, MD: For patients with relapsed or refractory myeloma, choosing the most optimal therapy depends on what they had before and what they tolerated. In the earlier lines, the go-to therapy has been a CD38 monoclonal antibody in combination with something. We cannot ignore the very impressive data that has been shown by CD38 monoclonal antibody therapy in combination with carfilzomib [Kyprolis], both from the CANDOR study [NCT03158688] and IKEMA study [NCT03275285]. [We saw] impressive progression-free survival data there. That’s starting to take hold a lot more, especially for patients with aggressive early relapses.

In the later relapses, I’m very impressed with the BCMA [B-cell maturation antigen] CAR T-cell therapy and the BCMA bispecific T-cell engager data. There’s also a potential role for the novel CELMoDs [cereblon E3 ligase modulators] if you incorporate them in combination. Then finally, there are drugs like selinexor [Xpovio] that can be used particularly in combination with other drugs that a patient may have seen long time ago but is ready to be exposed to [again].