Quiz: Managing Relapsed/Refractory Multiple Myeloma

December 16, 2019

In our multiple myeloma quiz, you'll get a chance to test your knowledge on best practices to treating patients with relapsed/refractory multiple myeloma

In our multiple myeloma quiz, you'll get a chance to test your knowledge on best practices to treating patients with relapsed/refractory multiple myeloma. Here's your first question:

1. In recent years, a new subset of multiple myeloma cases has been described involving refractory disease to which of the following treatments?
A. Proteasome inhibitors
B. Immunomodulatory agents
C. Monoclonal antibodies
D. All of the above

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Answer: D. All of the above. Most patients with multiple myeloma will develop treatment resistant disease for standard-of-care therapies, including proteasome inhibitors, immunomodulatory agents and monoclonal antibodies. Recently, a new subset of cases has been described: triple-class refractory multiple myeloma that is resistant to all 3.  

Reference:

Mickhael J. Treatment options for triple-class refractory multiple myeloma. Clinical Lymphoma, Myeloma & Leukemia. 2019;doi:10.1016/j.clml.2019.09.621.

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2. Penta-refractory myeloma resistant to bortezomib, lenalidomide, carfilzomib, pomalidomide, and daratumumab is associated with a median overall survival time of ____ months.

A. 3.6
B. 5.6
C. 7.6
D. 9.6

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B. 5.6 months. A 2018 retrospective study found that patients with penta-refractory myeloma have a median OS of just 5.6 months.

Reference:
Ghandi U, Lakshman A, Gahvari Z, et al. Natural history of patients with multiple myeloma refractory to CD38-targeted monoclonal antibody-based treatment. Presented at ASH Annual Meeting and Exposition; December 1-4, 2018; San Diego, California. Abstract 3233.

Please click here for next question.3. Treatment strategies for triple-class refractory multiple myeloma currently include which of the following?

A. Conventional chemotherapy
B. Salvage autologous stem cell transplantation
C. Recycling previously-attempted treatments
D. All of the above

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D. All of the above. Currently, triple-class refractory multiple myeloma treatment options are few but include conventional chemotherapy, salvage ASCT, or recycling previously-attempted treatment regimens. None of these options offer long-term efficacy and triple-class refractory disease is associated with poor survival.

Reference:

Mickhael J. Treatment options for triple-class refractory multiple myeloma. Clinical Lymphoma, Myeloma & Leukemia. 2019;doi:10.1016/j.clml.2019.09.621.

Please click here for next question.4. Investigational treatments for triple-class refractory multiple myeloma include which of the following?

A. CAR-T cell therapy
B. Selinexor
C. Next-generation monoclonal antibodies
D. All of the above

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D. All of the above. Numerous investigational agents and combination regimens are undergoing study for the treatment of refractory and triple-class refractory myeloma, including CAR-T cell therapies, selinexor, selinexor plus dexamethasone, and next-generation monoclonal antibodies.

Reference:

Mickhael J. Treatment options for triple-class refractory multiple myeloma. Clinical Lymphoma, Myeloma & Leukemia. 2019;doi:10.1016/j.clml.2019.09.621.

Please click here for next question.5. Which of the following can exclude patients from consideration for salvage ASCT?

A. Comorbidities
B. Frailty
C. Organ dysfunction
D. All of the above

Please click here for answer.

D. All of the above. Salvage ASCT should be considered for all eligible patients but many patients with refractory multiple myeloma will not be candidates because of advanced age, frailty, functional status, comorbidities and organ dysfunction.

Reference:

Mickhael J. Treatment options for triple-class refractory multiple myeloma. Clinical Lymphoma, Myeloma & Leukemia. 2019;doi:10.1016/j.clml.2019.09.621.