How do you approach post-transplant maintenance for patients with high-risk myeloma?

Topics: Hematologic Malignancies • Medical Oncology • Myeloma • NCI-CCC Tumor Board Question • Hematology • University of Washington • NCI-CCC Myeloma Tumor Board Question

Which PI and at what dosing intervals? Dexamethasone or not?

Emory has now published data with VRd consolidation as well as KPd consolidation, while FORTE has looked at KR. Which PI do you use, and q1wk or q2wk? Would you use MASTER-guided decision-making in certain patients even if they haven't received D-KRd upfront?

Answer from: Medical Oncologist at Academic Institution

I'm migrating the discussion from another thread ("Top Takeaways from ASCO 2023") here, mainly because the premise of this question is based on new data about KPd maintenance in high-risk patients presented by Dr. Nooka and colleagues as an oral presentation this past ASCO 2023.@Ben Derman's insight...

Answer from: Medical Oncologist at Community Practice

I think these thoughts make good sense, but I want to clarify what is high risk and what we know. I also don't think we should ever withhold effective therapy if it's available, in favor of 'saving it for later'; patients die with each relapse and hence we shouldn't save anything.My definition of hi...

Comments

Medical Oncologist at University of Washington, Fred Hutchinson Cancer Research Center
Excellently stated on all fronts - thank you, @Cra...

Medical Oncologist at Winship Cancer Institute of Emory University
Thank you for bringing up t(11;14). There ...

Medical Oncologist at Clinical Instructor
Dr. @Rahul Banerjee and Dr. @Craig C. Hofmeister, ...

Medical Oncologist at Winship Cancer Institute of Emory University
Good questions all. It's a data free zone that wil...

Medical Oncologist at BIDMC
Thanks to everyone for the robust conversation and...

Related Questions