The treatment landscape for transplant-ineligible newly diagnosed multiple myeloma (NDMM) patients has evolved significantly, thanks to key clinical trials such as PERSEUS, CASSIOPEIA, and GMMG HD7. These studies have provided valuable insights into the selection of initial treatment regimens, emphasizing the importance of risk stratification and the correlation between depth of response and patient outcomes.
When selecting initial treatment regimens, clinicians consider several factors, including the patient's overall health, disease characteristics, and potential for achieving minimal residual disease (MRD) negativity. Recent trials have highlighted the benefits of quadruplet over triplet regimens in certain patient populations, offering deeper and more sustained responses.
Trials like MAIA, BENEFIT, and CEPHEUS have further guided treatment decisions by providing evidence on the efficacy of maintenance therapy and the optimal timing for transitioning patients to such regimens. The choice between dual and triplet maintenance combinations, as well as the duration of maintenance therapy, is tailored based on individual patient risk profiles.
Personalizing treatment approaches based on patient characteristics is crucial for optimizing outcomes. Emerging strategies and ongoing trials continue to explore new avenues for improving frontline multiple myeloma care, with a focus on enhancing the depth and durability of responses while minimizing treatment-related toxicities.
As the field advances, treatment approaches are expected to become increasingly personalized, with a greater emphasis on achieving MRD negativity and leveraging novel therapeutic combinations to improve long-term survival and quality of life for transplant-ineligible NDMM patients.
