Mayo Clinic&nbsp;&nbsp;&nbsp;

How often do you assess for frailty in your clinical practice for patients with Multiple Myeloma and what tool do you use?

For example: eyeball test, simplified frailty assessment (Facon et al.), IMWG frailty score, ECOG only?

Based on the DREAMM-7 and DREAMM-8 data, if approved again in the US, how would you incorporate belantamab mafadotin in your practice?

Based on the IMROZ and BENEFIT data, would you recommend quadruplet therapy for non transplant eligible newly diagnosed multiple myeloma?

In the current myeloma landscape, do you make treatment decisions based on MRD results, either for MRD negativity or MRD resurgence?

With the recent ODAC review of the commerically available CAR-T therapies in relapsed/refractory myeloma post 1-3 lines of therapy, what is your preferred regimen/therapy for first relapse, and which are the situations where you would absolutely consider CAR-T therapy at first relpase?

Are there any circumstances where you recommend early institution of systemic therapy for patients with solitary plasmacytoma?

Specifically, do you offer closer follow-up for certain patients after local radiation?

With the CANOVA results in mind, would you continue using venetoclax in patients with multiple myeloma with t(11;14)?

What is your approach to mitigating the infection risk with bispecific antibodies in multiple myeloma?

4 Answers available

How do you choose between the different recently approved Bispecifics Antibodies for Relapsed/Refractory Multiple Myeloma?

I.e. dosing regimen frequency, side effect profile, duration of follow up, etc.

How do you manage IgM related peripheral neuropathy?

Do you utilize rituximab or any other specific management strategies?

Do you recommend routinely getting periodic 24-hour urine monoclonal protein study for patients with active multiple myeloma?

If so, why?

4 Answers available

Would you implement CAR-T therapy earlier in practice if approved in earlier lines for multiple myeloma based on the KarMMa-3 and CARTITUTUDE-4 studies?

Do you change treatment for confirmed biochemical progression in patients with otherwise secretory MM even if the M-spike is <0.5 g/dL?

What is your approach for using anticoagulation/aspirin in patients with multiple myeloma?

What is your preferred up-front treatment for transplant-eligible patients with primary (de novo) plasma cell leukemia?

What are your takeaways from the GPRC5D-Targeted CAR-T trial (Mailankody et al. NEJM Sept 2022) and any key differences compared to the BCMA directed products?

Is there a role for repeat CAR-T with a potentially different product in relapsed and refractory multiple myeloma?

Do you perform a periodic PET CT to screen for extramedullary disease in patients with MM who are in remission?

Where does Elotuzumab-based combination therapy, specifically EPd, fit in your treatment paradigm for relapsed MM?

Does sequence matter?

How do you approach treatment for a patient with a biochemical relapse while on maintenance lenalidomide after autologous stem cell transplant for multiple myeloma?

What factors (i.e. timing from transplant, dose, prior therapy) impact your decision?

How do you approach the decision to pursue early versus delayed autologous stem cell transplantation in newly diagnosed multiple myeloma?

What is your experience with using Frailty Index or other geriatric screening in making decisions for elderly patients with multiple myeloma?

Frailty Index per Palumbo et al. PMID 25628469Is it practical to apply in clinics? Have you made decision changes based on it?

What is your treatment of choice for triple class refractory multiple myeloma?

CAR-T (any specific preference of product?) vs bispecific antibodies vs any other specific agents not previously utilized?

Do you prefer carboplatin or cisplatin with etoposide for stage IV extra-pulmonary neuroendocrine carcinomas with a Ki-67 > 55%?

What is your preferred maintenance strategy for high risk multiple myeloma?

Would you consider PRRT re-treatment in a patient with a well differentiated NET previously treated with 4 cycles of PRRT?

What is the role of liver transplant in NET?