Case Study 2 - Question 3 | FocusOn Oncology

Decision 3

Patient history: Samuel, a 79-year-old patient with MM, returns for an oncology consultation at 16 months after initiation of DRd. He is considered ineligible for autologous stem cell transplantation. Samuel achieved PR at month 6, VGPR at month 8, and CR at month 12. He has continued treatment with daratumumab plus bortezomib and dexamethasone since month 9 after diagnosis. Thromboprophylaxis was stopped at month 9, but he has continued antiviral and antibacterial prophylaxis.

Comorbidities: Type 2 diabetes mellitus with worsened glycemic control.
Current presentation: Chemistry and hematology values remain stable, reflecting CR. Thrombocytopenia has resolved. No new findings have been detected on imaging tests. Samuel presents with chemotherapy-induced peripheral neuropathy.
Challenge: Samuel complains of fatigue, paresthesia, and functional limitations. His family reports that he is struggling to balance the medications needed to treat his MM, diabetes, and antiviral/antibacterial prophylaxis agents, and his adherence to oral medications has decreased. They ask about the possibility of discontinuing treatment and resuming therapy upon relapse.

Choose your next step:

a. Stop daratumumab/dexamethasone and continue bortezomib

b. Continue daratumumab and stop bortezomib/dexamethasone

c. Continue daratumumab and dexamethasone, reduce bortezomib dose to 1.0 mg/m²

d. Stop treatment and recommend long-term monitoring

Decision 3

Decision 3

Choose your next step:

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