Speaker says use the best regimen ASAP in MM

In frail patients, it’s always important to check which comorbidities are present using the Charlson comorbidity scale, Dr Palumbo said.

“Remember, when we put together age, chromosome abnormalities, and frailty, frailty is the most relevant prognostic factor when you add everything together,” he said.

“Two drugs versus 3 drugs doesn’t make much difference when you are starting to introduce treatment to these very frail patients with comorbidities.”

Minimal residual disease

Dr Palumbo indicated that a combination of MRI and PET-CT should be used for a more accurate indication of minimal residual disease.

“[W]e hope to have cure, [but] I don’t think, today, myeloma is a curable disease,” he said.

He clarified this by saying that patients who are in complete response and minimal residual disease-negative at 3 years do well, but, by 7 years, “something is happening.”

And at 10 years, progression-free survival has dropped off significantly, “telling us that cure is probably not yet there.”