Do you have any concerns about using checkpoint inhibitors in a patient with myeloma who has a second malignancy?

This is thankfully, a relatively rare occurrence, but one that still occurs. Either a second solid-tumor malignancy that seems to be related to antecedent high-dose melphalan and/or lenalidomide, or just the misfortune of developing a second cancer from other risk factors such as smoking.

In short, f...

In clinical trials, the development of a second malignancy (SM) has been considered as an indication to discontinue treatment. [Having seen people die from lenalidomide-related secondary cancer, I would very much hesitate to restart maintenance Tx in patients who develop SM]. In general, the overall...