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Relapsed Refractory Myeloma — RACP Adult Medicine MCQ

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HardHaematologyRelapsed Refractory MyelomaRACP Adult Medicine

A fit patient with relapsed myeloma has progressed after a proteasome inhibitor, an immunomodulatory drug and an anti-CD38 antibody. Disease expresses BCMA and a clinical trial is available. Which therapeutic class is specifically relevant?

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Correct answer: AA BCMA-directed cellular or bispecific-antibody therapy

The best answer is “A BCMA-directed cellular or bispecific-antibody therapy”. BCMA is highly expressed on plasma cells and can be targeted by CAR-T products or bispecific antibodies in appropriately pretreated relapsed myeloma. Choice depends on access, fitness, disease tempo and risks such as cytokine-release syndrome, neurotoxicity and infection. Reusing an ineffective single agent or targeting unrelated EGFR or BCR-ABL pathways is not rational.

Reference: eviQ: Multiple myeloma: https://www.eviq.org.au/haematology-and-bmt/multiple-myeloma