IMS 2026 | Current therapeutic landscape and unmet needs for patients with newly diagnosed myeloma

In newly diagnosed myeloma patients, there is an ongoing therapeutic revolution thanks, at first, to a new idea that the quadruplet is the new standard of care. This idea is based mainly on scientific trials that have shown incredible, outstanding results in terms of fast and deep response, adding CD38 to the VRd quadruplet. And particularly, we have, in transplant-eligible patients, a double option, daraVRd or IsaVRd based respectively on PERSEUS and GMMG-HD7 clinical trials, in which the data are absolutely outstanding in terms of deepness of response, and in which, at this moment, we are also having a new concept of maintenance with the idea of anti-CD38 plus lenalidomide, so dara-len is a maintenance, and this can maybe, in the future, correlate with the cure of multiple myeloma, because we know that patients achieving sustained MRD could be maybe, in the next future, able to stop the drugs, and this is something that we have explored in PERSEUS EML17 clinical trials. In the concept of transplant-ineligible, we can include also transplant-deferred patients. And this is another important point, because we know that some patients are, in some way, in a grey zone between transplantability or not. And in this idea, has also explored these categories of patients. And together with IMROZ, we have a double quadruplet combination with daratumumab and isatuximab combined with VRd, also in ineligible populations. I think that we have changed our ambition also in the elderly population and also in frail ones, because we know perfectly how we can obtain the deepest response, which can correlate maybe with one therapy for life. And this is the new objective, the idea that an elderly patient could probably have such a long response to die with myeloma, not for myeloma. That is an incredibly outstanding concept. The idea of achieving MRD negativity has become the real endpoint also for the elderly population. And particularly, in isatuximab-VRD-IMROZ combination, we can also obtain a new impact of OBI, because we know that we can administer subcutaneously through this tool, that is simple, is fast to use, and is safe, is really safe. We can impact positively on quality of life, tolerability, and also with the satisfaction from both the patient and the staff healthcare professionals. So, I think that OBI can be a game-changer in these settings, because we know that patients’ reported outcomes are really important, but also the shared decision-making can be something that, particularly in newly diagnosing the patient, can be, in my idea, impactful, and I think that the next future, we will see also the idea, maybe, of stopping a treatment, also in eligible patients, that will achieve the best response to sustaining them on negativity. The best has to come, but I think that, at this moment, we have many novelties to potentially use in our daily practice.

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