Dr. Bergsagel on Treatment Options for Relapsed/Refractory Myeloma

Leif Bergsagel, MD, consultant and professor of medicine, Division of Hematology/Oncology, Mayo Clinic, discusses treatment options for patients with relapsed/refractory multiple myeloma.

With the plethora of options for the treatment of patients with myeloma, choosing one regimen over another can be difficult for the oncologist, says Bergsagel. When choosing treatment, Bergsagel says to consider risk factors, previous treatments, and anticipated adverse events. Generally, a 3-drug regimen is superior to a 2-drug regimen in the relapsed/refractory setting, he adds.

Chimeric antigen receptor (CAR) T cells have recently entered the field. At the 2017 ASH Annual Meeting, therapy with the BCMA-directed CAR T-cell therapy bb2121 showed complete remissions for 56% of patients with relapsed/refractory multiple myeloma. The objective response rate for bb2121 was 94%, which consisted of a very good partial response or better for 89% of patients. Bergsagel says that there is question about durability of response for CAR T-cell therapy, but ongoing clinical trials may answer that.