Multidisciplinary Task Force: Mitigating Disease Burden and Health Care Disparities in Relapsed/Refractory Multiple Myeloma

With the complex and rapidly evolving treatment landscape of multiple myeloma, it is vital that clinicians not only understand factors for informing selection of current and emerging combination and sequential therapeutic strategies, but also employ interdisciplinary strategies for reducing disparities in relapsed/refractory multiple myeloma care. The development of novel therapeutic options has significantly improved treatment outcomes for patients with relapsed/refractory multiple myeloma; however, many patients face barriers to timely and appropriate treatment, including racial, ethnic, and socioeconomic disparities in health care delivery and services. While Black patients with multiple myeloma are more likely to have a lower-risk genetic profile, multiple myeloma remains twice as deadly in Black patients compared with White patients. Both Black and Hispanic patients experience a longer time from diagnosis to novel therapy initiation compared with non-Hispanic White patients, and they are also less likely to receive autologous stem cell transplant. Additionally, Black and Hispanic patients, as well as patients who are older or live in rural areas, are underrepresented in clinical trials of novel therapies, creating a poor reflection of the real-world patient population (Multiple Myeloma Research Foundation, 2023). In order to provide optimal health care delivery, this Multiple Myeloma Task Force provides a consensus opinion on mitigating disease burden and health care disparities in relapsed/refractory multiple myeloma. 

The Multiple Myeloma Task Force includes the following expert faculty members:  

  • Sikander Ailawadhi, MD (Co-Chair), Professor of Medicine in the Division of Hematology/Oncology and Lead of the International Cancer Center at the Mayo Clinic 
  • Rahul Banerjee, MD, FACP (Co-Chair), Assistant Professor in the Division of Medical Oncology at Fred Hutchinson Cancer Center at the University of Washington 
  • Yelak Biru, MSc, President and CEO of the International Myeloma Foundation 
  • Craig Cole, MD, Assistant Professor at Karmanos Cancer Institute 
  • Beth Faiman, PhD, MSN, APN-BC, AOCN®, BMTCN®, FAAN, FAPO, Nurse Practitioner at the Cleveland Clinic Taussig Cancer Institute
  • Shonali Midha, MD, Medical Oncologist at Jerome Lipper Multiple Myeloma Center and Instructor at Harvard Medical School and Dana Farber Cancer Institute

Using a metaphor from DNA replication, most of the advances in myeloma care have focused on the “leading strand” of cancer therapies: new drugs, new mechanisms of action, new combinations, new MRD-guided pathways. In this panel, we intentionally focus on the “lagging strand” of disparities and logistical barriers that need to be addressed before our patients can uniformly catch up to the bright future ahead in myeloma care.

Rahul Banerjee, MD, FACP

Watch this video to hear expert perspectives on:

  • The role that racial and socioeconomic disparities play in preventing patients from receiving optimal therapy for multiple myeloma and what initiatives are underway to reduce these disparities
  • How to select treatment for patients with relapsed and refractory myeloma
  • When to refer multiple myeloma patients for CAR T-cell therapy or bispecific antibody therapy
  • The role that measurable residual disease (MRD) testing plays in multiple myeloma treatment
  • Resources to keep physicians informed on practice-changing developments in multiple myeloma treatment

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