Abstract
Simple SummaryThe evolving data from trials assessing novel combinations as a part of the frontline and relapse treatment in transplant and non-transplant candidates have markedly improved the anti-myeloma efficacy of the different therapeutic regimens and improved patients’ prognosis. Current treatment objectives are focused to further improve the rate of complete remission, time to progression, progression-free survival and overall survival without increasing toxicity. Besides, different strategies are being developed in the elderly population as this group of patients requires a closer monitoring with individualized, dose-modified regimens to improve tolerability while maintaining their quality of life. This article presents a general description of the novelties of the whole treatment of multiple myeloma; from induction in the newly diagnosed patient through the role of hematopoietic stem cell transplantation and maintenance treatment until early and late relapses; including a section on recently approved drugs as well as novel drugs and immunotherapy in advanced stages of research.In the past 20 years, few diseases have seen as great progress in their treatment as multiple myeloma. With the approval of many new drugs and the limited availability of clinical trials comparing head-to-head the different possible combinations, the choice of the best treatments at each stage of the disease becomes complex as well as crucial since multiple myeloma remains incurable. This article presents a general description of the novelties of the whole treatment of multiple myeloma, from induction in the newly diagnosed patient through the role of hematopoietic stem cell transplantation and maintenance treatment until early and late relapses, including a section on recently approved drugs as well as novel drugs and immunotherapy in advanced stages of research, and that will surely play a relevant role in the treatment of this devastating disease in the coming years.
Highlights
Multiple myeloma (MM) is a malignant B-cell disorder characterized by the clonal proliferation of plasma cells in bone marrow typically associated with overproduction of monoclonal proteins that accumulate in serum and urine
Data from an integrated analysis of two studies from the Spanish myeloma group (GEM) including more than 500 patients with newly diagnosed MM (NDMM), and receiving pre-transplant induction with VTd or VRd showed that the rate of very good partial response (VGPR) or better and minimal residual disease (MRD)-negativity was significantly higher with VRd than with VTd (42% vs. 26%) [15]
In the transplant-setting are interesting the results achieved by the new quadruplet therapies including monoclonal antibodies, D-VTd and D-VRd
Summary
Multiple myeloma (MM) is a malignant B-cell disorder characterized by the clonal proliferation of plasma cells in bone marrow typically associated with overproduction of monoclonal proteins that accumulate in serum and urine These alterations lead to extensive disease manifestations including anemia, hypercalcemia, immunosuppression, and end-organ damage such as renal impairment and bone lesions [1,2]. Cancers 2020, 12, x FOR PEER REVIEW deaths in the USA for 2020 [3], while in Europe there are more than 48,000 new cases and around 31,000 deaths the [4]. USA for 2020 [3], while in Europe there are more than 48,000 new cases and around deaths eachinyear. With a good quality of life and perhaps achieve the so far elusive cure of the disease
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