Treatment Options for Patients With Heavily Pretreated Relapsed and Refractory Multiple Myeloma
Open accessAbstract
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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There is no standard of care for early triple-class-exposed relapsed and refractory multiple myeloma.
“Management of relapsed MM remains challenging; patients are becoming triple-class exposed (TCE) earlier in their treatment course, 4-8 with no standard of care for early TCE relapsed and refractory MM (R/RMM).”
From Ide-cel vs standard regimens in triple-class-exposed relapsed and refractory multiple myeloma: updated KarMMa-3 analyses. (2024) · cites this paper as [4]
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Self-citationRetractedIdecabtagene Vicleucel in Relapsed and Refractory Multiple Myeloma.
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Ide-cel or Standard Regimens in Relapsed and Refractory Multiple Myeloma
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- Authors
- Dimopoulos, M.-A., Richardson, P., & Lonial, S.
- Affiliations
- National and Kapodistrian University of Athens (GR)
- Dana-Farber Cancer Institute (US)
- Emory University (US)
- Corresponding author
- Dimopoulos, Meletios-Athanasios
- Venue
- Clinical Lymphoma Myeloma and Leukemia
- Publisher
- Elsevier BV
- Published
- 2022-07
- Volume
- 22
- Issue
- 7
- Pages
- 460-473
- ISSN
- 2152-2650 (ISSN-L)
- OpenAlex
- W4206792247
- Cited by
- 46
- References
- 8
- Citations by year
- 2026: 7 · 2025: 15 · 2024: 11 · 2023: 9 · 2022: 4
- FWCI
- 1.74
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Lymphoma Myeloma & Leukemia (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Bristol-Myers Squibb Co
- Topics
- Health Sciences › Medicine › Hematology › Multiple Myeloma Research and Treatments
- Health Sciences › Medicine › Oncology › Bone health and treatments
- Health Sciences › Medicine › Genetics › Chronic Lymphocytic Leukemia Research
- Keywords
- relapsed/refractory multiple myeloma, heavily pretreated patients, lenalidomide-refractory disease, bortezomib-refractory disease, anti-CD38 monoclonal antibody, pomalidomide, elotuzumab, daratumumab, isatuximab, carfilzomib, ixazomib, panobinostat, selinexor, proteasome inhibitors, immunomodulators, treatment sequencing, combination therapy
- MeSH terms
- Lenalidomide, Panobinostat, Antineoplastic Combined Chemotherapy Protocols, Humans, Multiple Myeloma, Neoplasm Recurrence, Local, Proteasome Inhibitors
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