Dr. Binod Dhakal and Dr. Prerna Mewawalla discuss the increasingly important distinction between anti-CD38 exposure and true anti-CD38 refractoriness in relapsed/refractory multiple myeloma (RRMM). As the majority of patients now receive anti-CD38-based therapies in frontline treatment, accurately characterizing disease refractoriness has become a critical component of treatment selection at relapse. Dr. Mewawalla explains how she differentiates between patients who are simply exposed to daratumumab and those whose disease is truly refractory, emphasizing the importance of recent treatment history and disease behavior. She highlights how this distinction directly influences second-line therapeutic decision-making, particularly when determining whether anti-CD38-based combinations remain appropriate options. The discussion underscores that exposure reflects prior treatment experience, whereas refractoriness reflects biologic resistance to therapy. Ultimately, the segment provides practical guidance for clinicians navigating an increasingly complex RRMM treatment landscape where anti-CD38 exposure is becoming the norm.
