IMS 2025 | Treatment goals and preferences in RRMM: patients and physicians

When we’re encountering patients with relapsed multiple myeloma, there is a very complex decision-making process that needs to occur. And this is because we have a wide variety of treatments available. We were particularly interested as to how patients may perceive their choices of immunotherapy now that we have access to bispecific antibodies, antibody drug conjugates, and CAR T-cell therapy. This can be quite daunting for patients. So what we did, we did a pan-European survey for over 100 patients where we asked them their views in terms of the decision-making process. This went to patients as well as healthcare providers and we tried to understand both of their views. What was very interesting is that you can break down the results according to the different patient groups and different patient groups seem to have different views. So for example, the older patients over the age of 65 or 70 years of age tended to focus more about adverse event management and improving their quality of life. When we spoke to those younger patients aged about 40 or 50, they were very keen not to disrupt their life. So their treatment choice was one that had minimal impact upon their family and working life. They were also quite reluctant to leave their current local caregivers and to be referred to another tertiary centre, for example, to receive CAR T-cell therapy. We also found that patients prefer to have a shared decision-making process with their physician, whereas when we speak to our physicians, we found that quite a number of physicians felt that they had to make the decisions for their patients. Now, again, interestingly, when you look at the younger patients, they were very keen on a shared decision-making process, whereas the older patients were happy for the clinician to guide them as to where they went. The final element was understanding how patients felt in remission or not. And what was interesting was that female patients tended to have more of a symptom burden with myeloma when they’re in remission compared to not. So in summary, I think it’s very important that a shared decision-making process is undertaken when talking to patients about novel immunotherapies. Because what’s very clear is that the patient’s priorities may not necessarily align with what the clinician feels may be the best treatment for the patient and you do need to come together to work out the best treatment moving forward.

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