ESMO E-Learning: Treatment of Patients with Multiple Myeloma

In this E-Learning module, the authors present  the goals of myeloma therapy, the potential role of early intervention in high risk smoldering multiple myeloma and put into context evidence from clinical trials for the treatment of patients with multiple myeloma in different settings, as well as considerations relevant  for the treatment of special populations.

In the first part of the module, the authors elaborate on minimal residual disease from the aspect of evaluation of treatment efficacy. This is followed by a rationale for early intervention in high risk smoldering multiple myeloma and evidence from clinical trials in that setting.

The following section elaborates on the optimal induction regimens for upfront management, covering questions about autologous stem cell transplant, the maintenance treatment, all illustrated by findings from multiple clinical trials in terms of efficacy and safety.

Consideration is given to treatment goals for non-transplant candidate patients; whether depth of response influences the outcome in elderly patients, the best front-line therapy, optimal regimens, whether monoclonal antibodies can be used in elderly patients and algorithms for individualised treatment.

The authors also elaborate on the factors to consider at the time of relapse; the best treatment for patients with disease refractory to lenalidomide, the options at first relapse, novel agents, what to do in patients who progress after two prior lines of therapy, and treatment of triple-class exposed patients, all supported by evidence from clinical trials and providing a summary of the current treatment landscape.