Dr. Tabbara on Treatment for Transplant-Eligible and -Ineligible Patients With Multiple Myeloma

Imad Tabbara, MD, professor of medicine, director of the Blood & Bone Marrow Transplant Program, and Fellowship Training Program, GW Cancer Center, discusses available treatment options for transplant-eligible and -ineligible patients with multiple myeloma.

The most standard regimen for transplant-eligible patients with multiple myeloma is a combination of bortezomib (Velcade), lenalidomide (Revlimid), and dexamethasone (RVd), explains Tabbara. Other regimens are available and are starting to be used more, including carfilzomib (Kyprolis), lenalidomide, and dexamethasone, says Tabbara. Newer studies suggest that adding monoclonal antibodies to this regimen, such as daratumumab (Darzalex), may improve the outcomes and create more durable responses for transplant-eligible patients with multiple myeloma, according to Tabbara.

For transplant-ineligible patients with multiple myeloma, lenalidomide and dexamethasone is appropriate, especially for older patients with comorbidities, says Tabbara. RVd-lite, a modified version of RVd, can also be used for this patient population. Additionally, there are newer studies combining chemotherapy with monoclonal antibodies, such as daratumumab, to treat transplant-ineligible patients with multiple myeloma, concludes Tabbara.