Treatment of Multiple Myeloma

The discussion shifted to treatment considerations for multiple myeloma, focusing on how decisions are influenced by both patient-specific and disease-specific factors. Clinicians assess the stage of the disease, chromosomal abnormalities, and whether the patient is considered high-risk or standard-risk. Additionally, the overall health of the patient—such as the presence of kidney impairment, high blood pressure, or diabetes—plays a critical role in shaping the treatment approach. These factors together help determine what intensity of treatment a patient can tolerate and which therapies are likely to be most effective.

For patients healthy enough to undergo intensive therapy, the standard of care now includes a four-drug regimen. This multi-agent treatment strategy has become widely accepted, particularly following a landmark clinical trial published in a major medical journal. The regimen typically involves four drugs used upfront, followed by an autologous stem cell transplant. After the transplant, patients receive consolidation therapy and then move into a long-term maintenance phase, often using two drugs to help sustain remission. This comprehensive, staged treatment strategy aims to deliver deep and lasting disease control.

The trial discussed—referred to as the Perseus Trial—demonstrated highly promising results. One of the most significant findings was the projected progression-free survival, which now approaches 200 months. This represents a major milestone in the treatment of multiple myeloma, signaling a substantial improvement in the ability to keep the disease in remission over the long term. The discussion framed this evolving treatment approach as a "whole package" strategy that integrates multiple stages of therapy, each contributing to more durable disease control and improved outcomes for patients.