NCI-CCC Myeloma Tumor Board Question   

What factors (i.e. timing from transplant, dose, prior therapy) impact your decision? 

Do the results change your clinical practice?

Does a progressing kappa/lambda ratio > 100 at any point in time warrant treatment, or does one wait to treat patients in the setting of a slowly i...

For pts w/ eGFR between 30-60

Frailty Index per Palumbo et al. PMID 25628469Is it practical to apply in clinics? Have you made decision changes based on it?

Venetoclax has demonstrated efficacy in patients harboring t(11;14) mutations but is not FDA approved for MM. Can you expand on what situations you ma...

For example: shorten IMiD duration each cycle, add scheduled G-CSF, add antibacterial prophylaxis, etc.

How do you decide how long to continue?

CAR-T (any specific preference of product?) vs bispecific antibodies vs any other specific agents not previously utilized?

Is a repeatedly abnormal serum immunofixation all it takes for MGUS?

Would you continue with daratumumab maintenance per ANDROMEDA or switch regimen?

What about multiple anaplastic plasmacytoma without bone marrow involvement?

How much weight do you give to a hgb/hct threshold versus symptoms?

Would you use MRD status to guide your decision making? 

If so, venetoclax/dexamethasone by itself or do you include a PI?

Is the therapeutic purpose of the proteasome inhibitor to maximize total dosage per week or number of infusions per week?