"You also want to deal with patient preferences. We do want to get their disease under control. We want to make them live a long, good quality of life. But do they want to come to the clinic once a week? Is it a far distance? Is geography a problem? Do they prefer not taking oral chemotherapies at home? We have to think about what the patient's preferences are to some degree and kind of incorporate that in our decision-making plan for treatments for relapsed and refractory myeloma," Ann McNeill, RN, MSN, APN, nurse practitioner at the John Theurer Cancer Center at Jersey Shore University Medical Center in Neptune, NJ, told Lenise Taylor, MN, RN, AOCNS®, TCTCN™, oncology clinical specialist at ONS, during a conversation about multiple myeloma treatment considerations.

Music Credit: "Fireflies and Stardust" by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by February 6, 2027. Ann McNeill has disclosed a speakers bureau relationship with Pfizer. This financial relationship has been mitigated. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to the treatment of multiple myeloma.

Episode Notes

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:
  • Episode 398: An Overview of Multiple Myeloma for Oncology Nurses
  • Episode 395: Pharmacology 101: Monoclonal Antibodies
  • Episode 372: Pharmacology 101: Proteasome Inhibitors
• ONS Voice articles:
  • Effective Care Transitions Are Essential for New Multiple Myeloma Treatments
  • New Multiple Myeloma Treatments Present New Challenges in Side Effect Management
  • Reduce Racial Barriers and Care Inequities for Black and African American Patients With Multiple Myeloma
• ONS Voice FDA approval alerts
• ONS Voice oncology drug reference sheets:
  • Belantamab mafodotin-blmf
  • Daratumumab
  • Motixafortide
  • Selinexor
• Clinical Journal of Oncology Nursing articles:
  • Journey of a Patient With Multiple Myeloma Undergoing Autologous Stem Cell Transplantation
  • Optimizing Transitions of Care in Multiple Myeloma Immunotherapy: Nurse Roles
• Oncology Nursing Forum article: Facilitators of Multiple Myeloma Treatment: A Qualitative Study
• ONS books:
  • Hematopoietic Stem Cell Transplantation: A Manual for Nursing Practice (third edition)
  • Multiple Myeloma: A Textbook for Nurses (third edition)
• ONS course: ONS Hematopoietic Stem Cell Transplantation™
• ONS Huddle Cards:
  • Financial Toxicity
  • Hematopoietic Stem Cell Transplantation (HSCT)
  • Monoclonal Antibodies
• ONS Hematology, Cellular Therapy, and Stem Cell Transplantation Learning Library
• American Society of Clinical Oncology (ASCO)–Ontario Health: Treatment of Multiple Myeloma Living Guideline
• International Myeloma Foundation:
  • Clinical Trials Fact Sheets
  • Clinical Trial Support
  • Resource Library
• Multiple Myeloma Research Foundation resource: Treatments for Multiple Myeloma

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

"Typically for our first-line therapies, we use certain classes of drugs and some of them are proteasome inhibitors like bortezomib and carfilzomib. We also have IMiDs or immunomodulatory agents like thalidomide, lenalidomide, and pomalidomide. We have monoclonal antibodies, anti-CD38 monoclonal antibodies. Of course, we can never talk about treatment for myeloma without mentioning dexamethasone. It is an integral part of our treatment regimen. Most of our frontline therapies now are not just a single agent. They're not even doublets anymore. Typically, they're triplet therapies. And now in 2026, it's leaning more toward quadruplet therapies. By that, I mean you're taking a proteasome inhibitor, an immunomodulatory drug, dexamethasone, and an anti-CD38 monoclonal antibody all together to present patients with a good chance their induction therapy will lead to a good chance of them responding to treatment." TS 4:25

"[With] myeloma labs, there should be some indication after each cycle of therapy that the treatment is working. So, you don't have to do a whole myeloma panel, but maybe getting a monoclonal protein spike, maybe getting a free light chain assay, or maybe an immunoglobulin G or immunoglobulin A level, just to see if the treatment is working. So, those labs are crucial to determine whether the therapies are working. And again, the lab improvements usually correlate with the clinical presentation of the patient." TS 11:01

"There are active clinical trials ongoing with drugs like cell mods. Cell mods are the new oral anticancer agents for myeloma that have shown great promise with efficacy and safety profiles. And then there are other combinations that are showing a lot of promise. So, drugs that are already approved by the U.S. Food and Drug Administration (FDA). And I'm talking about pairing anti-CD38 monoclonal antibodies with bispecific T-cell engagers. If you do that, there has been some evidence that these combinations are very efficacious and responses are durable. And there are ongoing clinical trials and studies being done right now to see if these can be FDA-approved to pinpoint where they are as far as in comparison to other treatments." TS 20:10

"I always tell patients to try to participate in safe, and I want to stress safe, physical activity. So, I tell patients, the more you sit on the couch or you sit in the chair for most of the day, that unfortunately will make your pain worse. So, trying to get up and about and doing some physical activity, such as getting a physical therapy evaluation and a treatment program, no matter how passive or mild or gentle it is, can really help these patients with bone pain." TS 26:10

"I think it's important to realize that myeloma has had amazing advances in science, research and treatments. I think that all of these things coming together, all the science and clinical trials and everything like that, has led to a significant increase in overall survival of our patients, which ultimately is a great thing. We want patients to live longer and they're living longer with a very good quality of life. So, I think it's important to realize that myeloma is very well studied, very well researched, and it's still ongoing with many, many clinical trials." TS 36:04