The Elderly Multiple Myeloma Patient in the Era of Quad Therapy and CAR-T Cells

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 15 July 2025 | Viewed by 125

Special Issue Editors


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Guest Editor
Adult Hematologic Malignancies & Stem Cell Transplant Section, Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
Interests: multiple myeloma; CAR-T; cellular therapy

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Guest Editor
UH Cleveland Medical Center, Euclid Ave, Cleveland, OH, USA
Interests: transplant; cellular therapy; heme malignancy

Special Issue Information

Dear Colleagues,

Multiple-myeloma therapy continues to evolve at a breakneck pace. Yearly, we are blessed with practice-changing clinical trials that change the treatment paradigm. Quadruplet induction and CAR-T cell therapy have improved clinical outcomes for new diagnosis and relapsed/refractory cases, respectively. The landmark clinical trial data have been recapitulated in multiple real-world datasets suggesting a generalizability of these findings. These regimens have very tolerable safety profiles, promoting deep clinical responses in both the “transplant-eligible” and the “transplant-ineligible” patient populations and may so fundamentally change our treatment paradigm that these designations may very well become a thing of the past.

As CAR-T and quadruplet therapies continue to gain new label indications, patient selection will become more important in clinical myeloma care. Despite the great outcomes with these agents, the medically frail patient remains challenging to treat. Indeed, while the landmark IMROZ trial included the “transplant-ineligible,” medically frail patients as well as patients > 80 years of age were excluded. While ide-cel , in general, has a more gentle side effect profile than cilta-cel, clinicians may be dissuaded from offering a CAR-T to an elderly patient and instead opt for a bispecific t-cell engager. Here, we invite you to share your expert opinion on the care of elderly and medically frail patients in the era of quadruplet induction and CAR-T cell therapy. By doing so, we hope to help inform clinical decision making that maximizes the therapeutic index of these interventions, helping to maintain a rigorous quality of life in these patients.

Dr. James J. Ignatz-Hoover
Prof. Dr. Koen Van Besien
Guest Editors

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Keywords

  • multiple myeloma
  • quad therapy
  • CAR-T
  • elderly

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