While the overall survival of patients with multiple myeloma (MM) has improved thanks to the introduction of effective therapies, treatment-related adverse events mean there has not been an accompanying improvement in quality of life. It is therefore crucial to optimize supportive care in order to maximize patients’ outcomes. The aim of this article was to review aspects of supportive care in MM.

The introduction of proteasome inhibitors, immunomodulatory drugs and monoclonal antibodies has improved the life expectancy of patients with multiple myeloma, and multidrug combinations have been associated with increased progression-free survival and depth of response. However, it is not clear whether these benefits lead to improved long-term overall survival (OS). The aim of this study was to assess the long-term OS of patients with multiple myeloma receiving high-dose, multidrug therapy, with or without bortezomib.

In the phase 3 IMROZ study, the addition of isatuximab to bortezomib, lenalidomide and dexamethasone (Isa-VRd) was associated with significantly improved progression-free survival (PFS) versus bortezomib, lenalidomide and dexamethasone alone (VRd) in transplantineligible patients aged 80 years or younger with newly diagnosed multiple myeloma (NDMM). Frail patients do not tolerate myeloma treatment regimens as well as fit patients and have worse outcomes. As such, the aim of this subgroup analysis of the IMROZ data was to investigate the efficacy of Isa-VRd followed by Isa-Rd versus VRd followed by Rd according to patient frailty.

There are no approved treatments for patients with smouldering multiple myeloma (MM) who are at high risk of progressing to active MM. Daratumumab is an anti-CD38 monoclonal antibody that is used to treat MM, and a phase 2 study has reported activity of daratumumab monotherapy in patients with intermediate- or high-risk smouldering MM. The aim of this study was to investigate whether daratumumab delays progression to active disease in patients with high-risk smouldering MM.