Amrita Krishnan, MD

Final Thoughts and Hope for a Cure

Multiple myeloma is a complex and evolving disease that demands healthcare providers maintain a strong understanding of both the illness and its treatments. It is important for care teams to establish mentorship and keep open lines of communication between specialists and community providers. A multidisciplinary approach is essential, involving doctors, pharmacists, social workers, and family members. This collaborative effort creates a supportive network that makes managing the challenges of myeloma more effective and comprehensive for patients.

From the patient and caregiver perspective, connection, education, and advocacy are crucial. Being involved in support groups or one-on-one coaching offers emotional support and guidance through the complexities of the disease. Learning about myeloma and the available treatments helps reduce anxiety and fosters hope, especially as new therapies continue to develop. Education empowers patients and caregivers to advocate confidently for the best care. The care process is both a science and an art, requiring continuous collaboration among experts to tailor the most up-to-date treatment plans to each individual’s needs.

Looking ahead, there is growing optimism about the future of myeloma treatment. Advances such as T cell–based therapies, including CAR T-cell therapy, are helping more patients achieve deep and lasting remissions. The ultimate goal extends beyond managing the disease to living well and fully, ready to benefit from ongoing innovations. With dedicated care teams, patient support systems, and rapid scientific progress, the journey with myeloma holds promise for hope, resilience, and meaningful growth.

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Panelists emphasize the importance of multidisciplinary collaboration, patient education, and advocacy in managing multiple myeloma, while expressing optimism about emerging therapies like CAR T cells that offer deeper remissions and improved quality of life.

Future Perspectives in Multiple Myeloma

Looking ahead, one of the most promising advances in myeloma treatment is T cell-directed therapy. Myeloma is influenced not only by the cancerous plasma cells but also by the surrounding immune environment. T cells, a key part of the immune system, can be harnessed to better fight the disease. One innovative approach involves removing a patient’s T cells, engineering them in a lab to specifically target myeloma cells, and then reinfusing them back into the patient. These engineered cells, known as CAR T cells, act like guided missiles attacking the cancer. Due to the complexity and potential side effects, CAR T therapy is administered at specialized centers with close monitoring for several weeks after treatment. Initially approved for patients with advanced, relapsed myeloma, it is now being studied and used in earlier stages of the disease.

Another exciting development is T cell engager therapy, which activates a patient’s existing T cells inside the body instead of removing them. This approach uses antibodies that simultaneously attach to both myeloma cells and T cells, bringing them together so the T cells can kill the cancer cells. These drugs received FDA approval recently but are still being introduced into broader use due to unique side effects and the need for specialist knowledge. Ongoing clinical trials are exploring their use in newly diagnosed and early relapse patients. Generally, the trend in myeloma treatment is to start with new, effective drugs in advanced stages and then move them into earlier treatment phases as their safety and benefits become clearer.

In addition to T cell therapies, newer drugs called CELMoDs are emerging. These are designed to be significantly more potent than older immunomodulatory drugs like Revlimid, potentially offering greater effectiveness with fewer side effects. Together, these advances represent a hopeful future for myeloma patients, offering more powerful and targeted treatment options that continue to improve outcomes.

Panelists highlight advances in myeloma treatment, focusing on innovative T cell therapies like CAR T and T cell engagers, along with potent new CELMoD drugs, all offering more targeted and effective options for patients.

Partnering with the Community

At City of Hope, the relationship with community physicians is viewed as a true partnership aimed at making treatment as accessible and convenient as possible. While it is recommended that all patients with myeloma consult at a specialized center for expert evaluation, ongoing care can often be managed closer to home. For example, common treatments such as Daratumumab, a chemotherapy drug used for many years, do not require patients to travel long distances. Instead, City of Hope works closely with local doctors to coordinate care, ensuring patients receive expert guidance while minimizing travel burdens.

Certain treatments, like stem cell transplants or enrollment in specialized clinical trials, are more complex and typically require care at a specialized center. For these cases, traveling to City of Hope or a similar center remains necessary to access the best care and newest therapies. However, beyond those specific needs, the goal is to simplify the patient experience by integrating community physicians into the treatment plan. This approach supports patients living with myeloma over many years, balancing high-quality care with convenience.

Overall, this ongoing partnership with community doctors allows patients to benefit from expert oversight and advanced treatments while maintaining much of their care close to home. It reflects an effort to reduce unnecessary complications in a patient’s life by combining specialized expertise with local support. By working together, City of Hope and community physicians strive to provide personalized, coordinated care that adapts to each patient’s evolving needs over the long course of myeloma treatment.

Panelists discuss City of Hope’s collaborative partnership with community physicians, emphasizing expert evaluation at specialized centers while enabling ongoing treatment closer to home for convenience, coordinating common therapies like Daratumumab locally, reserving complex procedures such as stem cell transplants and clinical trials for specialized centers, and aiming to balance high-quality care with patient accessibility through integrated, personalized, and coordinated management across care settings.

Support Systems and Multidisciplinary Treatment Approach

City of Hope offers a comprehensive, multidisciplinary approach to support patients through their myeloma journey. Beyond the core medical team, patients benefit from pharmacists who provide detailed medication guidance and social workers who offer emotional and practical support to both patients and their families. Palliative care specialists are also available to help manage symptoms and improve quality of life throughout treatment. Additionally, consultants such as cardiologists and infectious disease experts collaborate with the primary team to address specific health concerns, ensuring that complex issues like blood pressure control or infections are expertly managed. This team-based approach allows patients to receive coordinated care tailored to their unique needs.

One example of multidisciplinary care in action is managing side effects of specific myeloma drugs. For instance, some treatments can cause high blood pressure, requiring collaboration with cardiology to safely continue therapy. Similarly, neuropathy—nerve pain or numbness—can be a significant challenge for many patients. Palliative care and integrative medicine at City of Hope offer complementary therapies like acupuncture, Tai Chi, and mindfulness practices to help relieve these symptoms. These approaches work alongside conventional treatments to address both the physical and emotional aspects of living with myeloma, providing a holistic model of care.

Support groups play a vital role in helping patients and caregivers cope over the long term. Many find that emotional and social challenges become more pronounced years into their treatment, as they begin to process the impact of their diagnosis. These groups foster connection and encouragement by bringing together newly diagnosed patients and those who have been living with myeloma for many years. Sharing experiences creates a hopeful community where people can learn from one another and find strength in knowing they are not alone. This combination of expert medical care and strong psychosocial support is a hallmark of the patient experience at City of Hope.

Panelists discuss City of Hope’s multidisciplinary approach, highlighting pharmacists providing medication guidance, social workers offering emotional support, and palliative care specialists managing symptoms, while consultants like cardiologists and infectious disease experts address specific health issues to ensure coordinated, personalized care; complementary therapies such as acupuncture and mindfulness help manage side effects like neuropathy, and support groups foster community and resilience among patients and caregivers throughout their myeloma journey.

Amrita Krishnan, MD

Final Thoughts and Hope for a Cure

Future Perspectives in Multiple Myeloma

Partnering with the Community

Support Systems and Multidisciplinary Treatment Approach

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