S. Vincent Rajkumar, MD

Session moderator S. Vincent Rajkumar, MD, Professor of Medicine at the Mayo Clinic in Rochester, Minnesota, and Chair of the Mayo Clinic Myeloma, Amyloidosis, and Dysproteinemia Group, commented on the GMMG-CONCEPT trial and other studies in newly diagnosed patients. “There are two strategies to overcome high risk in myeloma: you can keep on intensifying the therapy, or you can keep on treating until your disease goes away—until the patient reaches MRD [measurable resideual disease] negativity,” he said.

“There is definitely encouraging news from this study,” he continued. The study showed that a quadruplet regimen—in this case, Isa-KRd—when given to newly diagnosed patients, can accomplish MRD negativity in two-thirds of transplant-eligible patients and about half of transplant-ineligible patients. The impact goes beyond just achieving MRD negativity. “These MRD negativity rates can be sustained as well,” he said. “And I was very impressed that with a quadruplet-type induction therapy, you can achieve a median progression-free survival of more than 4 years.”

Further discussing the abstracts from the session, Dr. Rajkumar said the emerging questions pertain to the duration of therapy once MRD negativity is attained and sustained and imaging remains negative. “With some patients, you can actually stop maintenance,” he said. “More research is needed on this front.” 

DISCLOSURE: Dr. Rajkumar reported no conflicts of interest.