Quadruple treatment: one step closer to optimal treatment of NDMM patients ineligible for ASCT?

Introduction

The webinar was moderated by Dr. Fredrik Schjesvold, head of the Oslo Myeloma Center in Norway. He emphasized the remarkable progress made in the treatment of elderly patients ineligible for transplants over the past year. The webinar was divided into three sections, each presented by distinguished speakers: Dr. Salomon Manier, Dr. Xavier Leleu, and Dr. Thomas Martin.

Treatment for NDMM Transplant-Ineligible Patients: A Historical Perspective

Prof. Salomon Manier from Lille University, France, provided an overview of the historical treatment landscape for transplant ineligible patients with NDMM. He highlighted the significant improvements in overall survival rates since 2008, primarily due to the development of immunomodulatory drugs (IMiDs) and proteasome inhibitors, and more recently, the addition of monoclonal antibodies targeting CD38. Dr. Manier discussed the evolution from broad clinical trials to more tailored approaches based on patient fitness and frailty, emphasizing the importance of dedicated clinical trials for different patient subgroups.

New advances in NDMM in patients not eligible for transplant

Prof. Xavier Leleu from Poitiers University Hospital, France, presented the latest advancements in treatment options for NDMM-TI patients. He discussed the results of recent phase 3 clinical trials, which investigated the efficacy of quadruple regimens incorporating monoclonal antibodies, proteasome inhibitors, and immunomodulatory drugs. These trials demonstrated significant improvements in progression-free survival (PFS) and minimal residual disease (MRD) negativity rates, highlighting the potential of quadruple regimens to enhance treatment outcomes.

How to select the right treatment for the right patient

Dr. Thomas Martin from UCSF, USA, focused on the practical application of these new treatment regimens in clinical practice. He emphasized the importance of individualized treatment plans based on patient frailty and fitness. Dr. Martin discussed the challenges of managing side effects and maintaining quality of life for elderly patients, advocating for a flexible approach that adapts to the patient’s needs and tolerability.

Key Takeaways

• Significant Progress in NDMM-TI Treatment: The approval of the new quadruple regimen represents a major advancement in the treatment of NDMM-TI patients, offering improved disease control and better management of the disease.
• Importance of Tailored Treatment: The shift towards tailored treatment approaches based on patient fitness and frailty is crucial for optimizing outcomes and minimizing side effects.
• Efficacy of Quadruple Regimens: Recent clinical trials have shown that quadruple regimens incorporating monoclonal antibodies, proteasome inhibitors, and immunomodulatory drugs significantly improve PFS and MRD negativity rates, providing a promising option for NDMM-TI patients.
• Managing Side Effects: Effective management of side effects is essential for maintaining quality of life and ensuring long-term treatment success. Individualized treatment plans and regular monitoring are key to achieving this.

Conclusion

The approval of the new quadruple regimen is a significant milestone in the treatment of NDMM-TI patients. The insights shared during the webinar underscore the importance of tailored treatment approaches and the potential of quadruple regimens to enhance the lives of patients with multiple myeloma. For more detailed information and key takeaways from the webinar, visit our Myeloma Platform website.

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