VIDEO: Late-stage myeloma treatment carries unique challenges

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Treating late stage myeloma has multiple challenges. First of all, patients are usually more refractory to the most commonly used agents. And we know from old cohorts that if we see patients, for example, with triple or penta class refractory disease, they usually don't do as well when it comes to response to the newer agents and/or duration of responses. We also now worry much about how the immune system of the patient is doing with more therapies. So there is evolving terms of T-cell fitness or rather you call it how the immune system is prepared to, you know, be used to fight cancer in a way. And that can get a little bit harder with longer use of other therapies or late line use of treatments. And I think we are going back to access.

We have problems of access for some of those therapies that are more complicated to be given to patients in the community where it's harder to then maybe to travel to more of a tertiary center or actually be able to be involved in a clinical study which may not be available for them where they live. So those are challenges that increase with time for patients who are late stage myeloma, specifically in case of refractoriness. And also the case of high risk myeloma that are hard to treat, including, for example, CNS myeloma or myeloma that is also reflecting on poor quality of life and/or you know, an older age, which means to be things that prevent you from using, for example, full doses of drugs that you otherwise use. We also worry about organ functions when, you know, when we have late stage myeloma, sometimes you have low blood counts that are more common. It could have been more organ failure including kidney, kidney function and alterations and so on.