Relapsed/Refractory Multiple Myeloma: A Review of Available Therapies and Clinical Scenarios Encountered in Myeloma Relapse
Multiple myeloma remains an incurable disease with the usual disease course requiring induction therapy, autologous stem cell transplantation for eligible patients, and long-term maintenance. Risk stratification tools and cytogenetic alterations help inform individualized therapeutic choices for pat...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/30/2/179 |
| _version_ | 1797621537954594816 |
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| author | Parva Bhatt Colin Kloock Raymond Comenzo |
| author_facet | Parva Bhatt Colin Kloock Raymond Comenzo |
| author_sort | Parva Bhatt |
| collection | DOAJ |
| description | Multiple myeloma remains an incurable disease with the usual disease course requiring induction therapy, autologous stem cell transplantation for eligible patients, and long-term maintenance. Risk stratification tools and cytogenetic alterations help inform individualized therapeutic choices for patients in hopes of achieving long-term remissions with preserved quality of life. Unfortunately, relapses occur at different stages of the course of the disease owing to the biological heterogeneity of the disease. Addressing relapse can be complex and challenging as there are both therapy- and patient-related factors to consider. In this broad scoping review of available therapies in relapsed/refractory multiple myeloma (RRMM), we cover the pharmacologic mechanisms underlying active therapies such as immunomodulatory agents (IMiDs), proteasome inhibitors (PIs), monoclonal antibodies (mAbs), traditional chemotherapy, and Venetoclax. We then review the clinical data supporting the use of these therapies, organized based on drug resistance/refractoriness, and the role of autologous stem cell transplant (ASCT). Approaches to special situations during relapse such as renal impairment and extramedullary disease are also covered. Lastly, we look towards the future by briefly reviewing the clinical data supporting the use of chimeric antigen receptor (CAR-T) therapy, bispecific T cell engagers (BITE), and Cereblon E3 Ligase Modulators (CELMoDs). |
| first_indexed | 2024-03-11T08:58:23Z |
| format | Article |
| id | doaj.art-e787eca954674fdf80a7f3b2ded585df |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-11T08:58:23Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-e787eca954674fdf80a7f3b2ded585df2023-11-16T19:58:27ZengMDPI AGCurrent Oncology1198-00521718-77292023-02-013022322234710.3390/curroncol30020179Relapsed/Refractory Multiple Myeloma: A Review of Available Therapies and Clinical Scenarios Encountered in Myeloma RelapseParva Bhatt0Colin Kloock1Raymond Comenzo2Tufts University Medical Center, Boston, MA 02145, USATufts University Medical Center, Boston, MA 02145, USATufts University Medical Center, Boston, MA 02145, USAMultiple myeloma remains an incurable disease with the usual disease course requiring induction therapy, autologous stem cell transplantation for eligible patients, and long-term maintenance. Risk stratification tools and cytogenetic alterations help inform individualized therapeutic choices for patients in hopes of achieving long-term remissions with preserved quality of life. Unfortunately, relapses occur at different stages of the course of the disease owing to the biological heterogeneity of the disease. Addressing relapse can be complex and challenging as there are both therapy- and patient-related factors to consider. In this broad scoping review of available therapies in relapsed/refractory multiple myeloma (RRMM), we cover the pharmacologic mechanisms underlying active therapies such as immunomodulatory agents (IMiDs), proteasome inhibitors (PIs), monoclonal antibodies (mAbs), traditional chemotherapy, and Venetoclax. We then review the clinical data supporting the use of these therapies, organized based on drug resistance/refractoriness, and the role of autologous stem cell transplant (ASCT). Approaches to special situations during relapse such as renal impairment and extramedullary disease are also covered. Lastly, we look towards the future by briefly reviewing the clinical data supporting the use of chimeric antigen receptor (CAR-T) therapy, bispecific T cell engagers (BITE), and Cereblon E3 Ligase Modulators (CELMoDs).https://www.mdpi.com/1718-7729/30/2/179relapsed/refractorymultiple myelomaimmunomodulatory agentsproteasome inhibitorsmonoclonal antibodiesautologous stem cell transplant |
| spellingShingle | Parva Bhatt Colin Kloock Raymond Comenzo Relapsed/Refractory Multiple Myeloma: A Review of Available Therapies and Clinical Scenarios Encountered in Myeloma Relapse Current Oncology relapsed/refractory multiple myeloma immunomodulatory agents proteasome inhibitors monoclonal antibodies autologous stem cell transplant |
| title | Relapsed/Refractory Multiple Myeloma: A Review of Available Therapies and Clinical Scenarios Encountered in Myeloma Relapse |
| title_full | Relapsed/Refractory Multiple Myeloma: A Review of Available Therapies and Clinical Scenarios Encountered in Myeloma Relapse |
| title_fullStr | Relapsed/Refractory Multiple Myeloma: A Review of Available Therapies and Clinical Scenarios Encountered in Myeloma Relapse |
| title_full_unstemmed | Relapsed/Refractory Multiple Myeloma: A Review of Available Therapies and Clinical Scenarios Encountered in Myeloma Relapse |
| title_short | Relapsed/Refractory Multiple Myeloma: A Review of Available Therapies and Clinical Scenarios Encountered in Myeloma Relapse |
| title_sort | relapsed refractory multiple myeloma a review of available therapies and clinical scenarios encountered in myeloma relapse |
| topic | relapsed/refractory multiple myeloma immunomodulatory agents proteasome inhibitors monoclonal antibodies autologous stem cell transplant |
| url | https://www.mdpi.com/1718-7729/30/2/179 |
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