In this medical education podcast series, myeloma experts Dr. Karthik Ramasamy (Haematologist and Associate Professor of Haematology at the Oxford University Hospitals in London, UK) and Dr. Joshua Richter (Assistant Professor of Medicine and Director of Myeloma at the Tisch Cancer Institute at the Icahn School of Medicine and the Blavatnik Family Chelsea Medical Center at Mount Sinai in New York, USA) discuss their experience and views on choosing the best treatment every time in multiple myeloma. In this second episode, Dr. Richter and Dr. Ramasamy explore how to select the best treatment approach in the second-line setting and beyond. Firstly, they discuss at what point they consider a patient to actually be in relapse. They both believe that it’s important to stay on top of this incurable illness and act when there is a suspicion of relapse. However, the need to treat must be balanced with quality of life. They also take potential enrolment into a clinical trial into account in the treatment decision. The decision on which treatment option to select in the second line and beyond mostly depends on refractoriness to other drugs. With an increasing number of novel treatment options becoming available, choosing a regimen that does not contain a drug the patient is refractory to is becoming easier. Dr. Richter and Dr. Ramasamy discuss the challenges around these treatment decisions. Furthermore, they share their experiences with CAR-T and other T cell redirection therapies, and when to use it in the treatment sequence. The speakers conclude with a look into the future of myeloma treatment.

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“What did the council decide on item 42?” — answered with the speaker and the moment.

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