b'u FromPage 19on more intensive novel regimens when there is evi- veterans, DuMontier said.dence lacking from clinical trial populations regard- We are even beginning to see the use of quadru-ing the safety and effectiveness of these regimens inplet (four-drug) regimens, and novel treatments such frailpatientstreatedinpractice,DuMontiersaid.as bispecific T-cell engager (BiTE) therapies for vet-In this way, frailty does not imply that less intensiveerans who have relapsed on prior therapies and until regimensshouldbeused,butratherthattreatmentrecently had little other options, he added. As with of multiple myeloma as a contributor of frailty mayour current study of bortezomib-lenalidomide-dexa-be treatment of frailty itself. Reevaluating frailty inmethasone, the safety and effectiveness of these ther-follow-up alongside reevaluating biochemical mark- apies should be confirmed as they are more widely ers of myeloma can help determine whether a patientused in the veteran population. Just because we found is improving in their health status, thus testing thethat a triplet regimen over a doublet regimen carries oncologists initial hypothesis about what was driv- a net benefit in frail veterans, does not mean that we ing the patients frailty. will find the same net benefit in frail patients treated Thanks to innovation in treatment, patients newlywith a quadruplet regimen over a triplet regimen.diagnosed with multiple myeloma can live an aver- 1DuMontier C, La J, Bihn J, Corrigan J, et. Al. More intensive therapy ageof10yearsorlonger.BesidesRdandVRd,as more effective treatment for frail patients with multiple myeloma newer, better-tolerated triplet regimens, such as dara- [corrected]. Blood Adv. 2023 Oct 24;7(20):6275-6284. doi: 10.1182/tumumab-lenalidomide-dexamethasone,areotherbloodadvances.2023011019. Erratum in: Blood Adv. 2023 Nov options that are now more commonly prescribed in28;7(22):7100. PMID: 37582048; PMCID: PMC10589796.Figure 4. Mortality of VRd vs. Rd within each frailty category and in combined overall population. Forest plot of HRs and 95% of CIs from Cox proportional hazards models evaluating association of VRd vs. Rd with mortality, based on frailty severity and in the combined overall population after matching or stage and PS within frailty categories.Source: More intensive therapy as more effective treatment for frail patients with multiple myeloma [corrected]. Blood Adv. 2023 Oct 24;7(20):6275-6284. doi: 10.1182/bloodadvances.2023011019. Erratum in: Blood Adv. 2023 Nov 28;7(22):7100. PMID: 37582048; PMCID: PMC10589796.20'