Dr. Martin on the Utility of Quadruplet-Based Regimens in Relapsed/Refractory Multiple Myeloma

Thomas G. Martin, MD, director of clinical research, clinical professor of medicine, Adult Leukemia and Bone Marrow Transplantation Program, associate director, Myeloma Program, co-leader, Hematopoietic Malignancies Program, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, discusses the potential utility of quadruplet-based regimens in relapsed/refractory multiple myeloma.

Some research has emerged regarding quadruplet-based approaches for patients with early relapsed multiple myeloma, Martin says. However, because quadruplets, such as daratumumab (Darzalex) plus lenalidomide (Revlimid), bortezomib (Velcade) and dexamethasone (RVd) or isatuximab-irfc (Sarclisa) plus RVd, are poised to become standard options in frontline transplant-eligible and -ineligible multiple myeloma, quadruplets may not be needed in the relapsed/refractory space, Martin explains.

For example, if a patient derives an up-front response with a quadruplet that lasts 6 or more years, the options available to treat their relapsed disease may be different from those available when they present with newly diagnosed disease, Martin says. At that time, BCMA-, CD3-, or GPRC5D-directed bispecific T-cell engagers in combination with lenalidomide or pomalidomide (Pomalyst) and dexamethasone could be standard regimens in the relapsed/refractory paradigm, Martin concludes.