In what clinical scenarios do you utilize venetoclax-based therapy in relapsed/refractory multiple myeloma?

Venetoclax has demonstrated efficacy in patients harboring t(11;14) mutations but is not FDA approved for MM. Can you expand on what situations you may recommend this? What is your preferred dosing schedule/timing? Or combination therapy?

Answer from: Medical Oncologist at Community Practice

I would caution that there is no strong data that the combination of Venetoclax with a proteasome inhibitor or a CD38 antibody makes sense; in fact, the addition is more likely than not to cause harm. Adding on to Venetoclax in patients that are naive to proteasome inhibitor or CD38 Ab naive...

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Medical Oncologist at University of Washington, Fred Hutchinson Cancer Research Center
Fair enough, and good point - so you would favor a...

Answer from: Medical Oncologist at Academic Institution

Disclaimer, before I comment, is that venetoclax is not FDA approved for myeloma and any use is off-label. The results for those with t(11;14) or high BCL2 expression are promising, but the phase 3 BELLINI study of Ven-Vd vs Vd showed inferior OS for Ven-Vd. This was mostly due to infection risk. So...

Answer from: Medical Oncologist at Academic Institution

Excellent question. Others (@Ben Derman and @Craig C. Hofmeister) had answered several of these subquestions in a prior thread here:https://www.themednet.org/question/10770.But we didn't fully address the ideal combo regimen to use in the appropriate setting - e.g., t(11;14) still present by FISH [B...

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In what clinical scenarios do you utilize venetoclax-based therapy in relapsed/refractory multiple myeloma?

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