Omar Nadeem, MD, a physician at Dana-Farber Cancer Institute and an instructor in medicine at Harvard Medical School, discusses individualizing therapy for patients with multiple myeloma.
As more therapies become available, more thought will have to be put into determining how best to sequence agents. In the relapsed setting, that will be the most important aspect of treatment, says Nadeem. If 4-drug regimens are adopted into the frontline setting, their impact on subsequent exposure to later lines of therapy and current standards of care, such as stem cell transplantation, will need to be assessed.
Escalation and de-escalation of therapy is another component of individualizing treatment. As such, tools are needed that will alert providers to when a patient who begins intensive therapy can de-escalate their treatment. These questions have never been truly asked before, says Nadeem. Over time, more medications and tools will be developed to individualize therapy for patients; this will be critical as no 2 patients with myeloma are alike, concludes Nadeem.