This Policy Review presents the International Myeloma Working Group’s clinical practice recommendations for the treatment of relapsed and  refractory  multiple  myeloma.  Based  on  the  results  of  phase  2  and  phase  3  trials,  these  recommendations are proposed for the treatment of patients with relapsed and refractory disease who have received one  previous  line  of  therapy,  and  for  patients  with  relapsed  and  refractory  multiple  myeloma  who  have  received  two or more previous lines of therapy. These recommendations integrate the issue of drug access in both low-income and middle-income countries  and  in  high-income  countries  to  help  guide  real-world  practice  and  thus  improve  patient outcomes.

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