Priority 9 from the Myeloma (Canada) PSP

UNCERTAINTY: What is the most effective way (i.e., drug combinations, sequence, frequency, and intensity) to treat refractory, relapsed, and drug resistant myeloma? (JLA PSP Priority 9)
Overall ranking 9
JLA question ID 0113/9
Explanatory note Participants would like to know the most effective ways to treat myeloma that is refractory or resistent to treatment from the outset as well as ways to treat the disease once it has relapsed. Specific concerns have to do with the re-combining treatments, the sequence of drugs, and when to re-start treatment. 
Evidence

 No evidence identified
Health Research Classification System category Cancer and neoplasms
Extra information provided by this PSP
Original uncertainty examples Is there another drug that could specifically target the cells that are resistant? ~ Options given treatment failure. ~ What will we do if the treatment doesn't work or if the cancer recurs?What are the optimal sequencing options for relapse/refractory treatment? ~ More data on retreating/recombining drugs that stopped working before. ~ How to treat relapsed myeloma ~ What treatments are available after the first occurrence of the disease? 
Submitted by Please see the PSP Engagement Summary on the JLA website  
PSP information
PSP unique ID 0113
PSP name Myeloma (Canada)
Total number of uncertainties identified by this PSP. 59  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 28 April 2021