From Satisfaction to Solutions: Unmet Needs, Future Regimens, and Anti-CD38 Formulary Management in NDMM

In this episode, 'From Satisfaction to Solutions: Unmet Needs, Future Frontline Regimens, and Anti-CD38 Formulary Management in NDMM,' the multiple myeloma experts explore the following questions:

1. How satisfied are you with the current standard of care for NDMM patients, and where do you feel the most significant unmet needs remain?
2. What would the ideal frontline regimen of the future look like to you, and how close do you think we are to achieving it?
3. Anti-CD38 monoclonal antibodies have become central to frontline regimens across transplant-eligible and transplant-ineligible patients alike. How have multiple anti-CD38 options changed how you think about frontline treatment selection?
4. From a pharmacy standpoint, how has the availability of multiple anti-CD38 options affected formulary management?

The panelists examined the significant progress made in frontline multiple myeloma treatment while emphasizing that true satisfaction will only come when more patients achieve a durable cure and can transition off maintenance therapy entirely, identifying MRD-guided treatment discontinuation as one of the most promising pathways toward that goal. The discussion also explored what the ideal frontline regimen of the future might look like, with the panelists highlighting the potential of CAR-T consolidation following quadruplet induction and the emerging role of T-cell engagers in attacking residual disease clones that survive initial therapy, framing a multi-pronged, synergistic approach to frontline treatment as the most promising direction for improving depth and durability of response. The panelists further addressed how the availability of multiple anti-CD38 agents has evolved formulary management in practice, noting that while early cost differentials and scheduling complexity initially drove formulary discussions, the conversation has shifted toward patient-centric considerations such as subcutaneous administration, chair time reduction, and rapid infusion protocols, all of which carry meaningful implications for both patient quality of life and total cost of care.

Throughout the conversation, the experts provide a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

The next episode in this series, 'Patient-Centered Frontline Decisions: Regimen Selection, Frailty Assessment, and High-Risk NDMM Management,' features the panelists advancing their conversation on multiple myeloma and focusing on how patient-specific factors including frailty, performance status, and comorbidities inform frontline regimen selection, and the unique challenges and emerging treatment options for high-risk newly diagnosed multiple myeloma patients.