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IMS 2026 | Treatment compatibility as a new approach to assessing frailty in myeloma
Gordon Cook, MB ChB, PhD, FRCP(Glas), FRCPath, Leeds Teaching Hospitals NHS Trust, Leeds, UK, discusses the concept of treatment compatibility as an alternative way of describing and assessing frailty in multiple myeloma. He highlights the need for more patient-centered language and emphasizes that treatment compatibility is dynamic and can change throughout the disease course. This interview took place at the 23rd International Myeloma Society (IMS) Annual Meeting in Glasgow, UK.
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Transcript
So frailty as a word is what we clinicians use to describe what we believe is an individual’s capability of tolerating treatment. The problem is that it’s quite a subjective word really. We took a small working group of patients and asked them what did frailty mean to them and they found it quite a harsh word and therefore we explained why we call it frailty, what we mean by it and then they understood and they still felt that the word was quite disparaging in terms of their outlook, quite pessimistic...
So frailty as a word is what we clinicians use to describe what we believe is an individual’s capability of tolerating treatment. The problem is that it’s quite a subjective word really. We took a small working group of patients and asked them what did frailty mean to them and they found it quite a harsh word and therefore we explained why we call it frailty, what we mean by it and then they understood and they still felt that the word was quite disparaging in terms of their outlook, quite pessimistic. And therefore looking at treatment compatibility, treatment tolerability, some kind of phrase that harnesses not the individuals. They felt that with the word frailty that they were being discarded, which is not the case. What we as clinicians are using it for is so we can tailor-make treatment. So there is a need to shift the language to try and actually focus on the patient and the treatment thereof. And of course the thing is that the frailty in myeloma terms is dynamic and therefore somebody who’s frail at diagnosis may not be frail by a year down the line, two years down the line, whatever. And that’s also going to be incorporated in any phraseology you give to identify somebody as being treatment compromised, treatment less compatible or whatever. So there’s an emotive nature and there’s also an accuracy nature. So the language has to change. But until 10 years ago, we hadn’t brought frailty into the conversation of treating myeloma so we have made progress we’ve got much more progress to do.
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