Recent clinical evidence supports new strategies for the management of patients with relapsed and refractory multiple myeloma (MM), including the use of both approved and investigational targeted agents, new dosing regimens for established therapies, and refined, individualized sequencing plans. These approaches have the potential to benefit both clinicians and payers who strive to enhance outcomes and provide value-based care in the relapsed/refractory setting.
Currently, it is difficult to identify high-value second-line and salvage therapies for patients with MM. Selecting treatments for relapsed/refractory disease is complicated by the multidrug regimens commonly used as frontline therapy.1 Double and triple therapies frequently include bortezomib, lenalidomide, and thalidomide with or without chemotherapy or a corticosteroid. Eligible patients may also undergo autologous stem cell transplantation as a component of early therapy. In addition, more and more patients are now receiving maintenance therapy, typically with lenalidomide or bortezomib.