Pretesting Prior to Quad Therapy for NDMM

Panelists discuss how comprehensive baseline testing before starting quadruplet therapy is crucial for safely guiding treatment decisions. They review standard pretherapy evaluations, including bone marrow biopsy, fluorescence in situ hybridization, and next-generation sequencing to detect cytogenetic abnormalities. They stress the importance of assessing renal, hepatic, and cardiac function to anticipate potential toxicities, especially with proteasome inhibitors and immunomodulatory drugs. In addition, infection risk and vaccination status are reviewed to ensure immune optimization before therapy. The panel also emphasizes that effective pretreatment planning facilitates early recognition of adverse events, supports dose modification strategies, and ultimately improves patient adherence and outcomes.