In this podcast episode, myeloma experts Dr. María Victoria Mateos (Haematologist at the University Hospital Salamanca, Spain) and Dr. Alexander Lesokhin (Associate Attending on the Myeloma Service at the Memorial Sloan Kettering Cancer Center, New York, NY, USA) discuss how they choose the best treatment regimen for patients with multiple myeloma and a high-risk cytogenetic profile. Firstly, they discuss the treatment options available for patients with high-risk cytogenetics in the US and in Europe. However, the key question is how to decide, for each individual, which treatment option is the best one. Dr. Mateos and Dr. Lesokhin discuss the factors they consider in these decisions in their clinical practice. Although the prior treatment is the most important consideration in the relapsed setting, the type of cytogenetic abnormality also plays a role. The experts specifically discuss treatment decisions in patients with extramedullary multiple myeloma: a difficult-to-treat population. The speakers also discuss the future of myeloma treatment. How should trial design be adapted to better meet the needs of patients with a high-risk cytogenetic profile? What will be the role of CAR-T and bispecific antibodies in this population? The experts conclude by summarising their key take-aways from the discussion.

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