Treatment Options for Patients With Heavily Pretreated Relapsed and Refractory Multiple Myeloma

Despite the increasing number of treatment options available for multiple myeloma, relapse is still inevitable and there remains a critical unmet need for treatments for patients with late-stage, highly refractory disease. In this review, we discuss currently approved treatment options for heavily p...

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Bibliographic Details
Published in:Clinical lymphoma, myeloma and leukemia Vol. 22; no. 7; pp. 460 - 473
Main Authors: Dimopoulos, Meletios-Athanasios, Richardson, Paul, Lonial, Sagar
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.07.2022
Subjects:
Anti-CD38 antibody
Elotuzumab
Heavily pretreated
Immunomodulatory drugs
Monoclonal antibodies
Multiple myeloma
Pomalidomide
Proteasome inhibitors
Relapsed/refractory
Immunomodulatory drugs
Multiple myeloma
Heavily pretreated
Monoclonal antibodies
Anti-CD38 antibody
Pomalidomide
Relapsed/refractory
Proteasome inhibitors
Elotuzumab
ISSN:2152-2650, 2152-2669, 2152-2669
Online Access:Get full text
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Summary:Despite the increasing number of treatment options available for multiple myeloma, relapse is still inevitable and there remains a critical unmet need for treatments for patients with late-stage, highly refractory disease. In this review, we discuss currently approved treatment options for heavily pretreated patients with relapsed and refractory multiple myeloma, with a focus on the optimal management of patients with MM refractory to lenalidomide, bortezomib, and in some cases, daratumumab or an anti-CD38 monoclonal antibody. Data from recent clinical trials of immunomodulatory agents (pomalidomide), proteasome inhibitors (PIs; carfilzomib and ixazomib), monoclonal antibodies (elotuzumab, daratumumab, and isatuximab), and other novel therapies (including panobinostat-based therapy) are summarized. We also provide potential therapeutic strategies for patients according to different treatment histories, and include case studies to illustrate the practical use of various treatment options in a clinical setting. Regimens containing pomalidomide, elotuzumab, next-generation PIs, panobinostat, or selinexor may provide effective treatment options in patients with triple-refractory disease. The choice of agents used, and combinations thereof should be individualized as well as strategically planned from early- to late-stage relapse.
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ISSN:2152-2650
2152-2669
2152-2669
DOI:10.1016/j.clml.2022.01.011