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IMS 2026 | Treatment strategies without access to BCMA- or GPRC5D-directed therapies
Martin Kaiser, MD, FRCP, FRCPath, The Royal Marsden NHS Foundation Trust, London, UK, discusses treatment strategies for patients with multiple myeloma at first relapse who do not have access to newer BCMA- or GPRC5D-directed therapies. He highlights established antibody, immunomodulatory drug and proteasome inhibitor-based combinations that can provide durable responses, while emphasizing the importance of preserving quality of life and avoiding cross-resistance with therapies that may become available in subsequent lines. This interview took place at the 23rd International Myeloma Society (IMS) Annual Meeting in Glasgow, UK.
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Transcript
If access to new drugs is not possible, if just because of the healthcare system or what can be just access to geography or other reasons is not possible. There are of course a whole range of combinations that are still giving good responses. We have had triplets of antibodies, monoclonal antibodies and IMiDs, for example, or IMiDs and proteasome inhibitors for a while. They are actually safe, they can be given and actually there are always proportions of patients that are responding very well to these treatments and that may stay in a long-term remission...
If access to new drugs is not possible, if just because of the healthcare system or what can be just access to geography or other reasons is not possible. There are of course a whole range of combinations that are still giving good responses. We have had triplets of antibodies, monoclonal antibodies and IMiDs, for example, or IMiDs and proteasome inhibitors for a while. They are actually safe, they can be given and actually there are always proportions of patients that are responding very well to these treatments and that may stay in a long-term remission. The important bit is that many of these combinations fortunately do not overlap in their resistance that can emerge over time with the newer drugs. They’re normally not targeting BCMA or GPRC5D so that actually hopefully over time access to these drugs improves and they can then be used at second relapse for example so I think the important thoughts to spend on there is what are treatments that are still giving good results at the moment maybe also keeping in mind that the patient might still gain access to these very effective treatments in subsequent lines of therapy and to choose a combination that might preserve quality of life as much as possible, maybe cause also lower long-term toxicities, because patients may still live a long time if they then access BCMA or GPRC5D targeting treatment subsequently.
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