Multiple Myeloma: Treatment Considerations and Role of MRD

Opinion
Video

The panel discusses the effect minimal residual disease (MRD) has on treatment selection and provides insights on the treatment of younger patients with standard risk.

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“Every patient [with multiple myeloma] should be offered CAR T before they’re offered a bispecific, with some rare exceptions,” said Barry Paul, MD.
Barry Paul, MD, listed cilta-cel, anito-cel, and arlo-cel as 3 of the CAR T-cell therapies with the most promising efficacy in patients with multiple myeloma.
Elucidating nonresponses to bispecific T-cell engagers may be an important research consideration in the multiple myeloma field.
Fixed treatment durations with bispecific antibodies followed by observation may help in mitigating infection-related AEs, according to Shebli Atrash, MD.
Shebli Atrash, MD, stated that MRD should be considered carefully as an end point, given potential recurrence despite MRD negativity.
The National ICE-T Conference may inspire future collaboration between community and academic oncologists in the management of different cancers.
Long-term toxicities like infections and secondary primary malignancies remain a concern when sequencing novel agents for those with multiple myeloma.
Management of adverse effects and access to cellular therapies among community oncologists represented key points of discussion in multiple myeloma.
“If you have a [patient in the] fourth or fifth line, [JNJ-5322] could be a valid drug of choice,” said Rakesh Popat, BSc, MBBS, MRCP, FRCPath, PhD.
Earlier treatment with daratumumab may be better tolerated for patients with pretreated MRD-negative multiple myeloma.
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