One of the challenges haematologists face in myeloma is how to treat frailer patients. Whilst the availability of proteasome inhibitors (PIs) (e.g. bortezomib [Velcade®], ixazomib [Ninlaro®] and carfilzomib [Kyprolis®]) and immunomodulatory agents (IMiDs) (e.g. thalidomide, lenalidomide [Revlimid®] and pomalidomide [Imnovid®]), have significantly improved the outcomes of myeloma patients in the last decade, frailer patients have shown a lesser improvement. This is mainly due to the toxicity some drugs can have in frailer patients, which may lead to subsequent early discontinuation of treatment.
Dr Sonja Zweegman, Professor of Hematology, Head of Department of Hematology in the VU University Medical Center, in Amsterdam (The Netherlands) explains this topic and other clinical challenges in this video: