The BOTTOM LINE: Several treatment options are available to relapsed myeloma patients. Consider your options carefully with your doctor.
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This week's "Ask Dr. Durie" comes from a patient who is concerned about relapse. He's been on low-dose maintenance for some time, but now, numbers are changing—increases in the myeloma protein have been noted. And the first question is: Has relapse occurred? But the question that this patient has is: Are there really good backup options for me to consider?
And so, the answer to that question is a definite yes. We have a lot of good backup therapies available today in 2022. As I said, the first thing is to double-check all the numbers with your doctor and make sure if the myeloma is progressing, if maybe there's a newborn lesion or other problems which may have emerged, if there clearly is evidence of early relapse, then this is the time to talk to your doctor and maybe even get input from a myeloma expert.
This can be done either in person or with a virtual consult, but this can be a really good time to talk about what are actually many options. The choice between these options is determined by what has happened from your initial diagnosis. What were the features of your myeloma? How did you respond? How well did you respond to your initial therapy and really, what is the status of your myeloma at this point in time?
Maybe you've even had a follow-up bone marrow with follow-up chromosome testing performed. And so, this is a really, really excellent time to review the testing and to review carefully all these different options. It is exciting. In addition, be aware that we have many new immune therapies which are available in clinical trials and a few of which have already been approved by the FDA, including belantamab, CAR-T therapies, and probably very shortly bispecific agent called teclistamab.
And so, the BOTTOM LINE for this patient is, yes, we have a lot of good options that are available. But a key point I would recommend in the setting is that because of the number of potential options, this really is a good time to think about getting input from a myeloma expert. And so, talk to your doctor about coordinating either maybe an in-person visit or maybe a virtual consultation.
Professor of Medicine, Hematologist/Oncologist, and Honoree MD at the University of Brussels, Dr. Brian G.M. Durie is a co-founder of the IMF and a member of the IMF Board of Directors.
