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IMS 2026 | Managing ultra-high-risk and double-hit multiple myeloma

Karthik Ramasamy, MBBS, MRCP, FRCPath, PhD, Oxford University Hospitals NHS Foundation Trust, Oxford, UK, discusses the management of patients with ultra-high-risk or double-hit multiple myeloma. He highlights the importance of close disease monitoring, noting that even patients who achieve very good partial or complete responses may relapse early, and emphasizes the potential role of maintenance strategies and clinical trials providing access to novel immunotherapies. This interview took place at the 23rd International Myeloma Society (IMS) Annual Meeting in Glasgow, UK.

These works are owned by Magdalen Medical Publishing (MMP) and are protected by copyright laws and treaties around the world. All rights are reserved.

Transcript

It’s important that clinicians recognize that this is a subset of patients who have a poor clinical outcome and therefore trying to monitor their disease very closely is critically important. So that’s one message. The second message I would give is often when we start patients on therapy, we all are quite happy then that they respond. And if they get a deeper response, like a very good partial response or a complete response, I mean, to a degree, we think that these patients may do well...

It’s important that clinicians recognize that this is a subset of patients who have a poor clinical outcome and therefore trying to monitor their disease very closely is critically important. So that’s one message. The second message I would give is often when we start patients on therapy, we all are quite happy then that they respond. And if they get a deeper response, like a very good partial response or a complete response, I mean, to a degree, we think that these patients may do well. But unfortunately, what we’re observing is even though these patients may get into a complete response or a very good partial response these patients will relapse earlier. So the earlier response that we see in these patients should not be an indicator for a better long-term outcome in these patients and therefore you need to continue to look at how do I maintain these patients in this deeper response meaning what best maintenance therapy I can give to these patients, are there clinical trials that I can include these patients into, which can give them access to a lot of these novel immunotherapies. So that’s my main message to oncologists.

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