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Multiple Myeloma Awareness: Bone marrow aspirate cytology of multiple myeloma, a type of bone marrow cancer of malignant plasma cells, associated with bone pain, bone fractures and anemia
Hot topics in RRMM: COMy 2024 expert picks

Transcript: Treatment selection

Last updated: 25th Jun 2024
Published:25th Jun 2024

Dr Hira Mian

Interview recorded Jun 2024. All transcripts are created from interview footage and directly reflect the content of the interview at the time. The content is that of the speaker and is not adjusted by Medthority.

So, I think for this one, you know, it's similar to when we think of treating a younger patient. You want to think of patient-specific characteristics, disease-specific characteristics, treatment-specific characteristics. So, an older adult, that patient-specific characteristic includes a frailty assessment. It includes also their social setting. Do they live alone? Do they have a caregiver? And also, increasingly, we're becoming aware of what would the patient want and what would their preferences be, especially in that relapse/refractory setting. I showed at COMy that there was data published earlier this year that, in fact, showed that 75% of older adults would actually pick better quality of life and functional status and cognitive status over outcomes like overall survival. So I think when we think of that bucket of patient characteristics, we really need to think about that particular aspect as well. On the second hand, we do need to think of disease characteristics. You know, so it's similar. Does this patient have high risk cytogenetics? Are they progressing with a biochemical or a clinical relapse? What's the tempo of their progression?

Because that ultimately decides what types of options and what the timing of those options will be. And on the third hand, we need to think of treatment-related characteristics. So we talked about proteasome inhibitors, for example. Does my patient have underlying neuropathy from previous exposure to proteasome inhibitor or previous toxicities that are still ongoing and will that limit my ability to what newer drugs to give to them? So I think both patient disease and treatment-related characteristics all together should inform how we treat older adults with relapse/refractory myeloma.

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