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Adriana Rossi, M.D., of the Multiple Myeloma Center at Weill Cornell Medicine and NewYork-Presbyterian Hospital in New York, spoke to Healio/HemOnc Today about the “revolutionary” advances being witnessed in terms of clinical approaches for the treatment of multiple myeloma.

“Every year we’re really making huge progress — not only in understanding the pathophysiology of the disease but actually translating that into new therapies,” she said.

Putting novel agents in context with past paradigms, Rossi highlights how far the field has come in personalizing treatment — moving beyond disease and risk to considerations including comorbidities, psychosocial support, and prior response and toxicities in the relapse setting.

“Hopefully, one day we will get to where we can sub-classify myeloma … and be able to approach a patient from the time of diagnosis based on their expected clinical course,” she said

Rossi covers the utility of triplet regimens and the questions remaining around transplantation, pointing to recent data from France comparing lenalidomide (Revlimid, Celgene), bortezomib (Velcade; Millennium Pharmaceuticals, Takeda Oncology) and dexamethasone with transplant, then touches on the promise of checkpoint inhibitors orCAR T cells in harnessing the power of the immune system to fight off myeloma.

Rossi also offers specific clinical insight on drug selection and sequencing, emphasizing “while it’s tempting to have an algorithm that specifies ‘this is how thou shalt treat myeloma, and these are the steps to take,’ it’s a wonderful problem to have that we can now tailor it to the patient.”