Therapy Selection and Management Strategies for Transplant-Ineligible Older Patients
Panelists discuss how newer immune-based therapies and bispecific antibodies may enable fixed-duration treatment approaches that could eliminate the need for stem cell transplant in older but fit patients, potentially allowing for treatment-free intervals after achieving deep responses.
Balancing Deeper Response and MRD Negativity With Toxicity Risks in Clinical Decision-Making
Panelists discuss how to balance achieving deeper MRD-negative responses against increased toxicity risks in transplant-ineligible patients by personalizing therapy through dose modifications, weekly vs twice-weekly dosing schedules, and careful monitoring while maintaining treatment intensity similar to clinical trials.
Navigating First-Line Therapy Guidelines and Treatment Considerations in High-Risk Cytogenetics
Panelists discuss how NCCN guidelines are expected to incorporate quadruplet-based regimens as reasonable treatment approaches for transplant-ineligible patients, while emphasizing the need for personalized treatment strategies that consider individual patient frailty and high-risk genetics rather than applying uniform approaches across all older patients.
Panelists discuss how the CEPHEUS trial demonstrated that quadruplet therapy (daratumumab, bortezomib, lenalidomide, and dexamethasone) significantly improved minimal residual disease negativity rates compared to triplet therapy in transplant-ineligible multiple myeloma patients, achieving approximately 60% vs 47% 10–5 responses while maintaining manageable safety profiles.
Panelists discuss how emerging therapies like CAR T cells and bispecific antibodies may transform frontline treatment by potentially replacing transplant or changing induction regimens, while considering the cost implications and need for sustainable care models.
Managing Early Relapse in Transplant-Eligible MM and the Influence of Clonal Evolution
Panelists discuss how early relapse in standard-risk patients represents a failure of current risk assessment methods and may require advanced sequencing technologies to identify hidden high-risk features that traditional fluorescence in situ hybridization testing misses.
Balancing Timing of ASCT: Insights on Delayed Transplantation and Long-Term Treatment Outcomes
Panelists discuss how autologous stem cell transplant (ASCT) deferral should be approached cautiously with concrete medical reasons, as transplant continues to provide superior progression-free survival and potentially curative outcomes for a subset of patients.
Tailoring Maintenance Therapy by Patient Risk: Lenalidomide Alone vs Combination Approaches
Panelists discuss how maintenance therapy should be tailored based on risk profiles, with standard-risk patients receiving single-agent lenalidomide while high-risk patients may benefit from combination maintenance strategies to achieve more durable responses.
The Role of MRD Status in Post-ASCT Treatment Decisions and Clinical Integration
Panelists discuss how minimal residual disease (MRD) status can guide post-transplant treatment decisions, particularly for high-risk patients who don’t achieve MRD negativity and patients considering discontinuation of long-term maintenance therapy.
Evaluating First-Line Treatment Options: Quadruplet vs Triplet Regimens and NCCN Guidelines
Panelists discuss how quadruplet regimens show improved efficacy over triplet regimens without significantly increased safety concerns, with anti-CD38 antibodies being well tolerated and NCCN guidelines now recommending 4-drug regimens for transplant-eligible patients.
Treatment Approaches and Goals: Transplant-Eligible vs. Transplant-Ineligible Patients
Panelists discuss how treatment strategies differ between transplant-eligible and transplant-ineligible multiple myeloma patients, with transplant eligibility determined by functional status rather than age alone, and how quadruple therapy regimens are increasingly used for transplant-eligible patients to achieve deep, durable responses.
Panelists discuss how autologous stem cell transplant remains essential in frontline multiple myeloma management despite improved quadruple therapy outcomes, emphasizing that current evidence still supports transplantation for eligible patients rather than deferring it.
Oral vs. Injectable HMAs: Patient Perspectives, Access, and IRA Impact
Medical experts discuss innovations and future directions in treatments for higher-risk MDSMedical experts offer patient perspectives on advantages and disadvantages of using oral HMAs vs injectable HMAs.
Innovations and Future Directions in Higher Risk MDS Treatments
Medical experts discuss innovations and future directions in treatments for higher-risk MDS.
HMA Persistence and Effectiveness in Higher Risk MDS
Medical experts offer insights on the persistence and effectiveness of HMAs in patients with higher-risk MDS.
Oral vs. Injectable HMAs: Convenience and Efficacy in Higher Risk MDS
Medical experts discuss convenience and efficacy in higher-risk MDS regarding oral vs injectable HMAs.
Advances in MDS Classification and Molecular Understanding
After a brief introduction, medical experts discuss advances in MDS classification and molecular understanding.