Self-Study 2025 Release II: The Four Body Problem: Four Drug Regimens in Newly Diagnosed Multiple Myeloma

Multiple myeloma (MM) remains an incurable disease; however, the development of new drug classes has led to significant improvement in overall survival. Historically, guidelines have recommended induction regimens containing three agents as the standard of care. This recommendation is based on results from studies evaluating three-drug regimens that demonstrated improved response rates, depth of response, progression-free survival (PFS) and overall survival (OS) compared to two-drug containing regimens. For patients with poor performance status or who are frail, a two-drug regimen may be initiated with the goal of adding a third agent if able. Recently, four-drug treatment regimens consisting of a CD-38 monoclonal antibody, proteasome inhibitor, immunomodulator, and dexamethasone have been evaluated in newly diagnosed MM patients who are transplant eligible or ineligible, as well as patients with relapsed or refractory disease. This module will review the safety and efficacy of four-drug regimens for the treatment of newly diagnosed multiple myeloma.