European Perspective on Multiple Myeloma Treatment Strategies in 2014
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| Title: | European Perspective on Multiple Myeloma Treatment Strategies in 2014 |
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| Authors: | Ludwig H., Sonneveld P., Davies F., Blade J., Boccadoro M., Cavo M., Morgan G., de la Rubia J., Delforge M., Dimopoulos M., Einsele H., Facon T., Goldschmidt H., Moreau P., Nahi H., Plesner T., San-Miguel J., Hajek R., Sondergeld P., Palumbo A. |
| Source: | Oncologist r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe instname ONCOLOGIST Instituto de Investigación Sanitaria La Fe (IIS La Fe) Ludwig, H, Sonneveld, P, Davies, F, Bladé, J, Boccadoro, M, Cavo, M, Morgan, G, de la Rubia, J, Delforge, M, Dimopoulos, M, Einsele, H, Facon, T, Goldschmidt, H, Moreau, P, Nahi, H, Plesner, T, San-Miguel, J, Hajek, R, Sondergeld, P & Palumbo, A 2014, ' European perspective on multiple myeloma treatment strategies in 2014 ', Oncologist, vol. 19, no. 8, pp. 829-844 . https://doi.org/10.1634/theoncologist.2014-0042 |
| Publisher Information: | Oxford University Press (OUP), 2014. |
| Publication Year: | 2014 |
| Subject Terms: | Dexamethasone/administration & dosage, Maintenance, Autologous stem cell transplantation, Transplantation, Autologous, Dexamethasone, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, Multiple myeloma, Antineoplastic Combined Chemotherapy Protocols, Humans, Risk stratification, Aged, Transplantation, Nontransplant setting, Hematopoietic Stem Cell Transplantation, Antineoplastic Combined Chemotherapy Protocols/administration & dosage, 3. Good health, Consolidation, Elderly patients, Europe, Treatment Outcome, Multiple Myeloma/epidemiology, EMC MM-02-41-03, Multiple Myeloma, Autologous |
| Description: | The treatment of multiple myeloma has undergone significant changes and has resulted in the achievement of molecular remissions, the prolongation of remission duration, and extended survival becoming realistic goals, with a cure being possible in a small but growing number of patients. In addition, nowadays it is possible to categorize patients more precisely into different risk groups, thus allowing the evaluation of therapies in different settings and enabling a better comparison of results across trials. Here, we review the evidence from clinical studies, which forms the basis for our recommendations for the management of patients with myeloma. Treatment approaches depend on “fitness,” with chronological age still being an important discriminator for selecting therapy. In younger, fit patients, a short three drug-based induction treatment followed by autologous stem cell transplantation (ASCT) remains the preferred option. Consolidation and maintenance therapy are attractive strategies not yet approved by the European Medicines Agency, and a decision regarding post-ASCT therapy should only be made after detailed discussion of the pros and cons with the individual patient. Two- and three-drug combinations are recommended for patients not eligible for transplantation. Treatment should be administered for at least nine cycles, although different durations of initial therapy have only rarely been compared so far. Comorbidity and frailty should be thoroughly assessed in elderly patients, and treatment must be adapted to individual needs, carefully selecting appropriate drugs and doses. A substantial number of new drugs and novel drug classes in early clinical development have shown promising activity. Their introduction into clinical practice will most likely further improve treatment results. |
| Document Type: | Article |
| Language: | English |
| ISSN: | 1549-490X 1083-7159 |
| DOI: | 10.1634/theoncologist.2014-0042 |
| Access URL: | https://europepmc.org/articles/pmc4122482?pdf=render https://pubmed.ncbi.nlm.nih.gov/25063227 https://fundanet.iislafe.san.gva.es/publicaciones/ProdCientif/PublicacionFrw.aspx?id=2103 https://theoncologist.onlinelibrary.wiley.com/doi/10.1634/theoncologist.2014-0042 https://portal.findresearcher.sdu.dk/da/publications/european-perspective-on-multiple-myeloma-treatment-strategies-in- http://theoncologist.alphamedpress.org/content/19/8/829.full https://repub.eur.nl/pub/71560 https://pubmed.ncbi.nlm.nih.gov/25063227/ https://onlinelibrary.wiley.com/doi/10.1634/theoncologist.2014-0042 https://portal.findresearcher.sdu.dk/da/publications/8305cbde-5205-4a34-80e1-6c7fd678c62b https://portal.findresearcher.sdu.dk/da/publications/8305cbde-5205-4a34-80e1-6c7fd678c62b https://doi.org/10.1634/theoncologist.2014-0042 https://hdl.handle.net/11585/905069 https://doi.org/10.1634/theoncologist.2014-0042 |
| Rights: | OUP Standard Publication Reuse |
| Accession Number: | edsair.doi.dedup.....13216b03be10cebdd63c1a4d089b6ff4 |
| Database: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstract: | The treatment of multiple myeloma has undergone significant changes and has resulted in the achievement of molecular remissions, the prolongation of remission duration, and extended survival becoming realistic goals, with a cure being possible in a small but growing number of patients. In addition, nowadays it is possible to categorize patients more precisely into different risk groups, thus allowing the evaluation of therapies in different settings and enabling a better comparison of results across trials. Here, we review the evidence from clinical studies, which forms the basis for our recommendations for the management of patients with myeloma. Treatment approaches depend on “fitness,” with chronological age still being an important discriminator for selecting therapy. In younger, fit patients, a short three drug-based induction treatment followed by autologous stem cell transplantation (ASCT) remains the preferred option. Consolidation and maintenance therapy are attractive strategies not yet approved by the European Medicines Agency, and a decision regarding post-ASCT therapy should only be made after detailed discussion of the pros and cons with the individual patient. Two- and three-drug combinations are recommended for patients not eligible for transplantation. Treatment should be administered for at least nine cycles, although different durations of initial therapy have only rarely been compared so far. Comorbidity and frailty should be thoroughly assessed in elderly patients, and treatment must be adapted to individual needs, carefully selecting appropriate drugs and doses. A substantial number of new drugs and novel drug classes in early clinical development have shown promising activity. Their introduction into clinical practice will most likely further improve treatment results. |
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| ISSN: | 1549490X 10837159 |
| DOI: | 10.1634/theoncologist.2014-0042 |