Value-Based Myeloma Care Amid Game-Changing Therapeutic Developments: Matias Sanchez, MD

The shift from broad chemotherapy regimens to targeted treatments, such as chimeric antigen receptor (CAR) T-cell therapy and bispecific antibodies, has improved overall survival and quality of life for patients with multiple myeloma, but implementing processes that ensure proper use of novel therapies is key for health systems and providers.

Matias Sanchez, MD, a hematologist-oncologist at University of Illinois Health and assistant professor of medicine in the Division of Hematology and Oncology at the University of Illinois College of Medicine, discussed major developments in multiple myeloma management and how health systems can support value-based, patient-centered care. Optimal myeloma management in the era of effective—and expensive—therapies was the topic of a session at a recent Institute for Value-Based Medicine^® (IVBM) event that Sanchez took part in.

This transcript has been lightly edited for clarity; captions are auto-generated.

Transcript

What new developments in multiple myeloma treatment have made the biggest impact on day-to-day practice in recent years?

Myeloma, I think, is one of the most interesting cancers that has had more developments than most other cancers recently. But I would say the use of minimal residual disease [MRD] in these patients, that's very important because we can tailor therapies in terms of giving them transplant. Most likely, for example, patients who are MRD negative will not need transplant, or we don't give them so much maintenance therapy if they're MRD negative; that's one thing. The use of MRD is one important thing.

But definitely the bigger winner is the use of the CAR T-cell therapies and the use of bispecifics—immunotherapy—that we've seen big, the best responses that we've never had in multiple myeloma. And there's a line of investigation that we're having there that will definitely continue to improve, so we're excited.

How can health systems and providers support value-based, patient-centered care for multiple myeloma?

Develop standardized procedures that we all follow to make sure that the quality and the care that we provide go in line with what we're doing in the clinical studies—but at the same time, without the cost that a clinical study brings. I think it is challenging for all the stakeholders involved, meaning people from the clinical standpoint, the laboratory, and the payers. We have to develop models that provide the best care but at the same time considering the cost—I think both are the things, so I think standardizing the procedures should be the first step, and then we can implement quality improvement projects on those. That's what we discussed [at the IVBM event], for example, all the strategies. I like what the people at Rush [University Medical Center] were doing and what they presented that day in the conference. They're using different strategies. For example, monitoring patients with this specific [tool] for patients who receive bispecifics. They give them what we call an outpatient telehealth monitor that can be used to monitor fever and vital signs. That should be reimbursed, for example—things like that.