Manni Mohyuddin: How I treat new myeloma

Manni Mohyuddin, Assistant Professor at the Huntsman Cancer Institute at the University of Utah, shared on X/Twitter:

“How I treat new myeloma:

– Fit/stnd-risk/wants transplant: DRVd > Auto > Len maint
– Fit/stnd-risk/transplant: DRVd (6-8c) > Len (or dara+len)
– Fit/high-risk: DRVD > Auto > Len or Len+K if accepts opportunity cost for small benefit
– Neuropathy: Use K (not V)

– Older/non-fit: DRd

Caveats:

– Standard risk/MRD neg after auto: Still recommend len maint- although I believe benefit small/needs tested in RCT
– Quads in those I didn’t transplant: Do not have good data to guide on how to de-escalate
– Only 1 high-risk cytogenetic: Usually NO doublet maintenance”

Source: Manni Mohyuddin/X