Dr. Waxman on the Future of Treatment in Multiple Myeloma

Adam J. Waxman, MD, MS, assistant professor of clinical medicine, Penn Medicine, University of Pennsylvania, discusses the future of treatment in patients with multiple myeloma.

The landscape of multiple myeloma is changing across settings and patient populations. As the data with quadruplet therapy mature, there is hope that the addition of daratumumab (Darzalex) to proteasome inhibitors and immunomodulatory drugs will show a progression-free survival advantage over triplet therapy, says Waxman. If quadruplet regimens translate to an overall survival improvement as well, they could become a new standard of care in transplant-eligible and -ineligible patients, Waxman adds.

Treatment approaches for elder patients are also changing. A year ago, older patients would have typically received a doublet, but have been unable to tolerate it. Now, these patients can receive daratumumab, which is very well tolerated, with either lenalidomide (Revlimid) or bortezomib (Velcade), says Waxman.

In the future, all newly diagnosed patients are likely to receive a triplet, if not a quadruplet therapy, predicts Waxman. In the relapsed setting, the field will see more novel combination treatments. Although multiple myeloma is a chronic disease, there is a growing list of combinations patients can receive to lessen their disease burden, which, in the future, may include BCMA-directed targeted therapies and CAR T-cell therapy, concludes Waxman.