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ASH 2024 | A dynamic approach to managing frail patients with multiple myeloma
Meral Beksac, MD, Istinye University Ankara Liv Hospital, Ankara, Turkey, provides insight into some key considerations when managing frail patients with multiple myeloma (MM), advocating for a dynamic approach that uses regular frailty assessments to guide treatment strategies and allow for the escalation of therapy to maximize treatment outcomes. This interview took place at the 66th ASH Annual Meeting and Exposition, held in San Diego, CA.
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Transcript (AI-generated)
Frailty is becoming more and more important. Why? Because newer drugs are more effective, but they also have their own toxicity profiles. And when elderly patients present with a more frail condition, we need to adapt our treatment strategy. And instead of going to a single drug, which is less effective, we may start with less intensive approaches, as many drugs as possible, to have an efficacy so that the disease-related frailty issues may decrease in time to allow the patients to have more drugs to be given to give them, again, an increase in their response rate...
Frailty is becoming more and more important. Why? Because newer drugs are more effective, but they also have their own toxicity profiles. And when elderly patients present with a more frail condition, we need to adapt our treatment strategy. And instead of going to a single drug, which is less effective, we may start with less intensive approaches, as many drugs as possible, to have an efficacy so that the disease-related frailty issues may decrease in time to allow the patients to have more drugs to be given to give them, again, an increase in their response rate.
So this is a very dynamic approach and we need to measure frailty. There are multiple scores in the field, but the IMWG frailty assessment seems to be the most widely accepted one. And sometimes it’s very practical based on the patient’s independence from the family to be able to perform on their own financial issues physically. These are very basic things that can have an impact on the treatment decision and also the success rate of the treatment. So we have to decide to give the most intensive regimen that the patient can tolerate versus a more frail patient who cannot afford it. And so despite the efficacy of that regimen in another population will be inferior in such a population. So everything is based on your judgment at diagnosis, but it has to be dynamic. We have to measure it with each step so that we can allow to escalate treatment to be able to reach the level of patients who are more fit in the beginning.
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Disclosures
Janssen: Research Funding, Speakers Bureau; Sanofi: Speakers Bureau; Bristol Myers Squibb: Speakers Bureau; Takeda: Membership on an entity’s Board of Directors or advisory committees; Amgen: Speakers Bureau; GSK: Research Funding; Menarini: Consultancy, Other: advisory.
