Lilian,

81-year-old Asian womana

Lilian does not want to burden her son, who is her caregiver, as she faces her next treatment. Consider how you would balance priorities for disease control, QOL, and caregiver needs during treatment discussions with your care team

Background

  • Elderly widow living with MM for almost a decade

MM diagnosis

  • After experiencing fatigue and back pain that would not go away, Lilian was diagnosed with MM

Current health, MM status, and concerns

  • Recently developed macular degeneration and is legally blind
  • Relapsed MM with osteoporosis, generalized pain, and neutropenia (low levels of white blood cells)

Her son, who is her caregiver, lives nearby and helps with daily tasks, but she finds it increasingly harder to cope with her treatment

Lilian's Treatment History

  • 54 MOFirst treatment: Lilian declined stem cell transplant due to personal preference but responded well to an initial 3-drug combination regimen (PI, IMiD, and a steroid) and continued with an IMiD for maintenance therapy
  • 30 MO First relapse: Following relapse, she switched to a different
    3-drug combination regimen (anti-CD38 mAb, PI, and a steroid)
  • 11 MO Second relapse: Lilian’s doctor started her on a different
    mAb-based 3-drug combination regimen (mAb, IMiD, and a steroid). Her disease responded and stayed in remission for 11 months
  • 14 MO Third relapse: Lilian next tried a 2-drug combination regimen
    (PI and a steroid). Her disease responded and stayed in remission for 14 months
  • 4 MO Fourth relapse: Following relapse, Lilian tried a 2-drug combination regimen, including an oral therapy (a selective inhibitor of nuclear export and a steroid). Her disease progressed after 4 months
  • Now: Fifth relapse
Treatment Goals and Considerations
  • Her doctor is considering treatments that prioritize limiting severe side effects while controlling the disease
  • Lilian agrees and prefers a treatment that also
  • ‒Limits impact on her carer
  • ‒Allows her to maintain her QOL

aThis patient profile is hypothetical and represents a type of patient typically seen in clinical practice.

CD, cluster of differentiation; IMiD, immunomodulatory drug; mAb, monoclonal antibody; MO, months; MM, multiple myeloma; PI, protease inhibitor; QOL, quality of life.