Partnering With All Patients: Ensuring Shared Decision Making and Evidence-Based Management for Underrepresented Groups With Multiple Myeloma

Author:

Cerchione Claudio1,Grant Shakira J.2,Ailawadhi Sikander3ORCID

Affiliation:

1. Hematology Unit, Istituto Romagnolo per lo Studio dei Tumori, Meldola, Italy

2. Department of Medicine, Division of Hematology, University of North Carolina, Chapel Hill, NC

3. Division of Hematology-Oncology, Mayo Clinic, Jacksonville, FL

Abstract

Several landmark therapeutic advances in multiple myeloma (MM) have led to an unprecedented number of options available to patients and their physicians as shared decision making is attempted. A myriad of factors need to be considered to ensure that patient-, disease-, and treatment-related factors are addressed to arrive at the most appropriate choice for patients at that time in their journey with myeloma. Some of these factors have traditionally remained underaddressed but have a clear association with patient outcomes, leading to underrepresented groups of patients with MM, including the elderly patients, racial-ethnic minorities, and those with specific advanced comorbidities, for example, renal insufficiency. Some of these factors may not be modifiable, but data suggest that they may give rise to implicit or explicit bias and affect treatment decisions. A growing body of literature is bringing these factors to light. However, their incorporation in day-to-day decision making for patients needs to be universal. It is imperative that prospective data are generated for all these and other underrepresented groups such that evidence-based medicine is applicable universally to all patients with MM, irrespective of clinical and sociodemographic factors.

Publisher

American Society of Clinical Oncology (ASCO)

Subject

General Medicine

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