Optimizing Therapy for Patients With RRMM


Advice for clinical pharmacists who help manage patients with relapsed/refractory multiple myeloma in the current era of novel therapies and recommendations to improve upon current practice patterns.

Bhavesh Shah, RPh, BCOP: That’s all the time we have for today. I want to thank all of you for this rich, engaging conversation and for sharing your best practices and your dreams, Ryan. Before we conclude, I want to have one final thought from each panelist in regard to advice they have for a pharmacist treating multiple myeloma. Doug, I went with you last; I’m going to start with Heather.

Heather Pound, PharmD, BCPS, BCOP: I think one thing for clinical pharmacists managing myeloma is to not underestimate the power of supportive care. Certainly as we have talked about, all of these different therapies and exciting things that we have, we still need to make sure that they’re receiving appropriate antimicrobial therapy. Do they need a bone modifying agent? With the renal dysfunction, do we need to adjust any of their myeloma therapy or any of the other medications that they might be on? Those are always the things that are in the back of my mind for patients with myeloma as well.

Bhavesh Shah, RPh, BCOP: Thank you, Heather. And then, Robert, you’re next.

Robert Mancini, PharmD, BCOP, FHOPA: For me the biggest thing in myeloma, because it is so complex and there’s so much going on, it’s good to have resources and know what your resources are and how to utilize them. Whether that be working with the MSLs [medical science liaisons] who handle these drugs, or having other contacts with centers that are similar to your own to see how they’ve dealt with certain things or operationalized certain things. Because in the end, understanding the quirks of these medications, how to manage them, how to support these patients is really important for the success of the treatment as well as for our own well-being, so that we do have dreams rather than nightmares.

Bhavesh Shah, RPh, BCOP: Well said. Ryan?

Ryan Haumschild, PharmD, MS, MBA: From the pharmacy director position, I’ve got to say there are a lot of innovative things coming down the pipeline; it’s exciting. It’s really important though that we do create some type of pathway development, we have some standardization of approach as we’re seeing more centers bring on more practices and be aligned, really that consistency of care, still making sure that it is patient specific when needed. But having a consistency of care is going to help us drive consistent quality outcomes, understand the expense and the utilization trends, and be as consistent as possible, especially as we are entering into a value-based contracts.

Then lastly, it’s so important that we figure out these operations. If you haven’t heard me say dream enough, it’s not going away, and I think it’s going to offer great hope to our patients in the future. Let’s figure out these operational hurdles, connect with the right people, and make sure that that’s never a limiting factor in the medication we chose for patients.

Bhavesh Shah, RPh, BCOP: Well said, thank you so much, Ryan. Doug?

Douglas Braun, CSP, PharmD, RPh: I’m super excited about where we are, where we’ve come, how far we’ve come in such a short period. Like you mentioned at the start with the prehistoric regimens and the only therapy we had, and that was only a few years ago. Now we’ve got all these choices for patients, we’ve got tons of stuff in the pipeline, everything we’ve discussed today. It’s really exciting for our patients to know that we’ve got options, if something fails, we’ve got something to replace it. If they progress on disease, we’ve got more options, and it’s only going to get better and better as we move on. I’m very excited to be able to continue to provide great help and service to our patients.

Bhavesh Shah, RPh, BCOP: Thank you, Doug. I want to thank everyone again, the panelists and also the audience. I hope that everyone found this Directions in Oncology Pharmacy® Peer Exchange discussion to be useful and informative.

Transcript edited for clarity.

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