Therapeutic options for MM have undergone a dramatic change such that the horizons for patients have been transformed. As providers, we have witnessed a remarkable improvement in outcomes that have meaningfully changed possibilities for long-term response for many of our patients. The recent experiences with immune-based therapies even in advanced disease have been incredibly promising. There is great reason for hope when confronting this disease.

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However, with this change comes the need to navigate through multiple therapies, chronic treatment, visits to the clinic, and the potential for toxicities that come with cumulative exposure to treatment. In addition, we continue to face the challenges of determining what the optimal sequencing of therapy is, how best to support patients on long-term treatments while finding the right balance of disease control and limiting side effects, and how to eventually get to a cure. The idea of cancer being a chronic, long-term battle that is open-ended and uncertain is a challenging one. Patients must try to remain present in their day-to-day lives and not lose their identity to this disease.

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We continue to strive toward improving therapy to extend life and to create periods when a patient may not need to be on ongoing therapy. We have a better understanding of toxicities, which, hopefully, will give us more opportunities to prevent and treat them. We are still innovating and creating opportunities for better responses, understanding when we should treat patients with MM and when we should leave them alone, and integrating immunotherapies in ways that may help us get to a cure.

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In addition, helping patients thrive medically and emotionally while undergoing chronic therapy is critical. It takes the support of loved ones and the medical community, along with mental health resources. We are working with patients to understand how to make sure that the treatments we choose are both effective and tolerable and that patients have a sense of agency and feel that they are a part of their own care. My patients with MM learn to persevere through the ongoing challenges that MM creates with poignancy and courage. One of the amazing things about this specialty is the sense of connection we develop with our patients and their families over time. This is an incredible privilege from which we draw inspiration and insights into the precious nature of each person we care for.