We would typically check monthly spot protein to creatinine ratios. This would be managed by both the nephrologist and oncologist as far as when to hold the drug. Would also recommend secondary workup and rule out other etiologies of proteinuria where myeloma has been reported in patients with renal...

I would agree with Dr. @Abudayyeh's comments, especially as they related to shared decision-making with the patient's treating oncologist.