Refractory to Imid, PI, anti CD38, and BCMA approaches
This node defines the clinical scenario of heavily pretreated/refractory RRMM where guidelines recommend clinical trials and use of remaining active drug classes (including bispecific antibodies and targeted therapy in biomarker-selected patients). References apply indirectly by framing standard-of-care options and the refractory disease context rather than a single intervention. Watch Dr. Rajkumar's intro video on Treatment of Refractory Multiple Myeloma (1:19).
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Treatment options
Venetoclax if t(11;14) Talquetamab or Talquetamab combination Other non-BCMA immunotherapy (eg., cevostamab or GPRC5D CART on a clinical trial) Alkylator-based regimens (VCd, KCd, IV melphalan) BCMA Bispecific Combinations Selinexor-based regimen Combination chemo (VDT-PACE, CVAD, DPACE) Bendamustine-based regimens