The ABCs of MM Treatment According to Rafael Fonseca, MD

By Chadi Nabhan, MD, MBA, FACP - Last Updated: October 5, 2023

Dr. Fonseca offers his thoughts on the future of multiple myeloma (MM) treatment, the ongoing debate between chimeric antigen receptor (CAR)-T therapies and bispecifics, and the latest treatment news on bispecifics, including elranatamab, which had yet to receive accelerated approval at the time of this recording.

The conversation also covers the role of measurable residual disease (MRD), the potential for bispecific therapies to democratize access to advanced treatments, and the intriguing prospect of CAR-T cells potentially replacing hematopoietic stem cell transplants in the first relapse—a scenario reminiscent of lymphoma care.

“I don’t think it’s far-fetched to think that there’s going to be a good number of patients with multiple myeloma that will be proposed as CAR T-cell candidates now at the time of first relapse, you know, similar to what has been seen in lymphoma,” Dr. Fonseca said.

Additionally, the conversation touched on the paradigm shift toward prioritizing deeper responses, including MRD negativity as a potential avenue to achieve long-term cure for some myeloma patients.

“I think the debate of cure versus control in myeloma is pretty much very clear that for those that are capable and those that are fit, the intention should be to try to lead to the deepest responses,” he said.

Find all episodes of The HemOnc Pulse here.

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