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Cited by 27Multiple Myeloma Research and TreatmentsChronic Lymphocytic Leukemia ResearchMonoclonal and Polyclonal Antibodies Research

Sequencing multiple myeloma therapies with and after antibody therapies

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van de Donk, Niels W. C. J.·2020·Hematology
DOI 10.1182/hematology.2020000109PMC PMC7727523
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Abstract

In multiple myeloma (MM), treatment selection and sequencing become increasingly complex with the increasing number of therapeutic options, including antibodies. Choice of treatment is dependent on various factors including patient- and tumor-related features. In addition, treatment-related factors, such as type and response to prior therapy, are also critical in terms of the selection of a new treatment regimen. Furthermore, approval status and reimbursement policies influence treatment choice. At the time of first relapse, patients who received a bortezomib-based regimen can switch to lenalidomide-based treatment, whereas patients who received lenalidomide until progression can switch to a proteasome inhibitor–based therapy. Alternatively, there is increasing evidence that pomalidomide-based triplets are also effective following the development of lenalidomide-refractory disease both in early and later relapse settings. Patients who become refractory to immunomodulatory drugs, proteasome inhibitors, and CD38 antibodies have a poor prognosis. These triple-class refractory patients may benefit from novel, recently approved agents such as XPO1 inhibitors or from participation in a clinical trial. Furthermore, retreatment with agents that were received in previous lines of therapy can also be considered in heavily pretreated patients, for example, in combination with classic cytotoxic drugs. Importantly, with the increasing use of CD38 antibodies in newly diagnosed and early relapsed/refractory MM, more information is needed on the potential value of retreatment with CD38 antibodies. With the introduction of new immunotherapies with novel modes of action, we also need a better understanding of sequencing of immunotherapeutic agents by taking into account the effect of prior therapy on immune function.

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References 66 · Cited by 27

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Authors
van de Donk, N. W. C. J.
Affiliations
Department of Hematology, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam University Medical Centers (UMC), Amsterdam, The Netherlands
Venue
Hematology
Publisher
American Society of Hematology
Published
2020-12-04
Volume
2020
Issue
1
Pages
248-258
ISSN
  • 1520-4383 (ISSN-L)
  • 1520-4391
DOI
10.1182/hematology.2020000109
PMC
PMC7727523
OpenAlex
W3109351395
Cited by
27
References
66
Citations by year
2026: 3 · 2025: 7 · 2024: 6 · 2023: 6 · 2022: 1 · 2021: 4
FWCI
1.74
Type
journal article
Language
en
Open access
Locations
  • Hematology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • 62nd ASH Annual Meeting and Exposition
Topics
  • Health Sciences › Medicine › Hematology › Multiple Myeloma Research and Treatments
  • Health Sciences › Medicine › Genetics › Chronic Lymphocytic Leukemia Research
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Monoclonal and Polyclonal Antibodies Research
Keywords
multiple myeloma, treatment sequencing, antibody therapy, lenalidomide, bortezomib, proteasome inhibitors, pomalidomide, XPO1 inhibitor, relapsed/refractory multiple myeloma, retreatment, immunotherapy, immunomodulators, treatment selection
MeSH terms
Bortezomib, Antineoplastic Agents, Immunological, Lenalidomide, Aged, Antineoplastic Combined Chemotherapy Protocols, Dexamethasone, Humans, Immunotherapy, Male, Multiple Myeloma, Neoplasm Recurrence, Local, Thalidomide, High-Throughput Nucleotide Sequencing

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