As hosts of the Oncology Brothers podcast, we had the privilege of discussing newly diagnosed multiple myeloma with Dr. Caitlin Costello from UC San Diego. Dr. Costello emphasized the importance of updated diagnostic criteria and highlighted the shift towards identifying biomarkers for early intervention. She stressed the significance of a comprehensive workup including blood tests, bone imaging, and bone marrow biopsy.
When it comes to treatment, Dr. Costello emphasized the individualized approach based on risk stratification and patient characteristics. For transplant-eligible patients, quadruplet therapy with daratumumab was recommended for better outcomes. For transplant-ineligible patients, triplet therapy with lenalidomide and dexamethasone was suggested, with a focus on tolerability and durability of response.
The discussion also touched on monitoring response post-induction therapy, with a focus on minimal residual disease (MRD) as a potential surrogate endpoint. Dr. Costello highlighted the importance of maintaining MRD negativity and the ongoing research in this area. The conversation also delved into maintenance therapy post-transplant, with considerations for standard-risk and high-risk patients.
In cases of multiple myeloma with renal failure, Dr. Costello recommended an urgent start with a combination of monoclonal antibody, bortezomib, and dexamethasone to address kidney damage caused by light chains. The episode concluded with practical tips for community oncologists, including the importance of discontinuing dexamethasone, monitoring biomarkers, and providing prophylaxis for potential complications.
Overall, the episode provided valuable insights into the evolving landscape of multiple myeloma treatment, emphasizing the need for personalized approaches and ongoing research to improve patient outcomes. Stay tuned to the Oncology Brothers podcast for more updates in hematology oncology.
