Cited by 19Multiple Myeloma Research and TreatmentsChronic Lymphocytic Leukemia ResearchLymphoma Diagnosis and Treatment

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Revisiting the role of alkylating agents in multiple myeloma: Up-to-date evidence and future perspectives

Costa, Bruno Almeida, Mouhieddine, Tarek H., Ortiz, Ricardo J., Richter, Joshua·2023·Critical Reviews in Oncology/Hematology

DOI 10.1016/j.critrevonc.2023.104040

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Abstract

From the 1960s to the early 2000s, alkylating agents (e.g., melphalan, cyclophosphamide, and bendamustine) remained a key component of standard therapy for newly-diagnosed or relapsed/refractory multiple myeloma (MM). Later on, their associated toxicities (including second primary malignancies) and the unprecedented efficacy of novel therapies have led clinicians to increasingly consider alkylator-free approaches. Meanwhile, new alkylating agents (e.g., melflufen) and new applications of old alkylators (e.g., lymphodepletion before chimeric antigen receptor T-cell [CAR-T] therapy) have emerged in recent years. Given the expanding use of antigen-directed modalities (e.g., monoclonal antibodies, bispecific antibodies, and CAR-T therapy), this review explores the current and future role of alkylating agents in different treatment settings (e.g., induction, consolidation, stem cell mobilization, pre-transplant conditioning, salvage, bridging, and lymphodepleting chemotherapy) to ellucidate the role of alkylator-based regimens in modern-day MM management.

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Authors: Costa, B. A., Mouhieddine, T. H., Ortiz, R. J., & Richter, J.
Affiliations: Icahn School of Medicine at Mount Sinai (US)
Tisch Cancer Institute (US)
Corresponding author: Richter, Joshua
ORCID: Costa, Bruno Almeida
Mouhieddine, Tarek H.
Ortiz, Ricardo J.
Richter, Joshua
Venue: Critical Reviews in Oncology/Hematology
Publisher: Elsevier BV
Published: 2023-07
Volume: 187
Pages: 104040
ISSN: 1040-8428 (ISSN-L)
DOI: 10.1016/j.critrevonc.2023.104040
OpenAlex: W4378212210
Cited by: 18
References: 256
Citations by year: 2026: 3 · 2025: 8 · 2024: 6 · 2023: 1
FWCI: 0.92
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
doi.org/10.15223/policy-017 (stm-asf)
doi.org/10.15223/policy-037 (stm-asf)
doi.org/10.15223/policy-012 (stm-asf)
doi.org/10.15223/policy-029 (stm-asf)
doi.org/10.15223/policy-004 (stm-asf)
Locations: Critical Reviews in Oncology/Hematology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Hematology › Multiple Myeloma Research and Treatments
Health Sciences › Medicine › Hematology › Chronic Lymphocytic Leukemia Research
Health Sciences › Medicine › Pathology and Forensic Medicine › Lymphoma Diagnosis and Treatment
Keywords: alkylating agents, multiple myeloma, melphalan, cyclophosphamide, bendamustine, melflufen, lymphocyte depletion, CAR T-cell therapy, second primary malignancy, relapsed/refractory multiple myeloma, stem cell mobilization, pre-transplant conditioning, consolidation therapy, bridging therapy
MeSH terms: Bendamustine Hydrochloride, Receptors, Chimeric Antigen, Alkylating Agents, Cyclophosphamide, Humans, Multiple Myeloma

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Revisiting the role of alkylating agents in multiple myeloma: Up-to-date evidence and future perspectives

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