Age is an important prognostic factor in multiple myeloma, with patients aged over 75 years showing inferior outcomes when compared to younger patients. Several factors play into the poor survival observed, including a higher incidence of severe disease, and high rates of comorbid conditions and functional impairment. However, the elderly population is heterogeneous, ranging from fit and active to frail and dependent. Thus, caring for older adults with myeloma is complex, with many patient factors influencing outcomes.
The clinical approach in this patient population must be modified to account for comorbidities and the likelihood of higher treatment-related toxicity. The introduction of proteasome inhibitors (PI) in the last 20 years was a huge step to improving survival in elderly patients. These advancements have continued, with ongoing investigations into optimal PI-based combinations and other novel agents.
In this Post-COMy 2021 Myeloma Session, Mohamad Mohty, MD, PhD, Saint-Antoine Hospital, Paris, France; Thierry Facon, MD, Lille University Hospital, Lille, France; and Alessandra Larocca, MD, PhD, of the University Hospital Città della Salute e della Scienza, Torino, Italy, discuss the latest in the treatment of elderly multiple myeloma. Featuring insights into how elderly myeloma treatment evolved to where we are today, frailty assessment, the challenges associated with the extremes of the frailty spectrum, and a look towards the future.
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