From transplant to novel cellular therapies in multiple myeloma: European Myeloma Network guidelines and future perspectives
Standard
From transplant to novel cellular therapies in multiple myeloma: European Myeloma Network guidelines and future perspectives. / Gay, Francesca; Engelhardt, Monika; Terpos, Evangelos; Wäsch, Ralph; Giaccone, Luisa; Auner, Holger W; Caers, Jo; Gramatzki, Martin; van de Donk, Niels; Oliva, Stefania; Zamagni, Elena; Garderet, Laurent; Straka, Christian; Hajek, Roman; Ludwig, Heinz; Einsele, Hermann; Dimopoulos, Meletios; Boccadoro, Mario; Kröger, Nicolaus; Cavo, Michele; Goldschmidt, Hartmut; Bruno, Benedetto; Sonneveld, Pieter.
in: HAEMATOLOGICA, Jahrgang 103, Nr. 2, 02.2018, S. 197-211.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - From transplant to novel cellular therapies in multiple myeloma: European Myeloma Network guidelines and future perspectives
AU - Gay, Francesca
AU - Engelhardt, Monika
AU - Terpos, Evangelos
AU - Wäsch, Ralph
AU - Giaccone, Luisa
AU - Auner, Holger W
AU - Caers, Jo
AU - Gramatzki, Martin
AU - van de Donk, Niels
AU - Oliva, Stefania
AU - Zamagni, Elena
AU - Garderet, Laurent
AU - Straka, Christian
AU - Hajek, Roman
AU - Ludwig, Heinz
AU - Einsele, Hermann
AU - Dimopoulos, Meletios
AU - Boccadoro, Mario
AU - Kröger, Nicolaus
AU - Cavo, Michele
AU - Goldschmidt, Hartmut
AU - Bruno, Benedetto
AU - Sonneveld, Pieter
N1 - Copyright© 2018 Ferrata Storti Foundation.
PY - 2018/2
Y1 - 2018/2
N2 - Survival of myeloma patients has greatly improved with the use of autologous stem cell transplantation and novel agents, such as proteasome inhibitors, immunomodulatory drugs and monoclonal antibodies. Compared to bortezomib- and lenalidomide-based regimens alone, the addition of high-dose melphalan followed by autologous transplantation significantly improves progression-free survival, although an overall survival benefit was not observed in all trials. Moreover, follow up of recent trials is still too short to show any difference in survival. In the light of these findings, novel agent-based induction followed by autologous transplantation is considered the standard upfront treatment for eligible patients (level of evidence: 1A). Post-transplant consolidation and maintenance treatment can further improve patient outcome (1A). The availability of several novel agents has led to the development of multiple combination regimens such as salvage treatment options. In this context, the role of salvage autologous transplantation and allotransplant has not been extensively evaluated. In the case of prolonged remission after upfront autologous transplantation, another autologous transplantation at relapse can be considered (2B). Patients who experience early relapse and/or have high-risk features have a poor prognosis and may be considered as candidates for clinical trials that, in young and fit patients, may also include an allograft in combination with novel agents (2B). Ongoing studies are evaluating the role of novel cellular therapies, such as inclusion of antibody-based triplets and quadruplets, and chimeric antigen receptor-T cells. Despite encouraging preliminary results, longer follow up and larger patient numbers are needed before the clinical use of these novel therapies can be widely recommended.
AB - Survival of myeloma patients has greatly improved with the use of autologous stem cell transplantation and novel agents, such as proteasome inhibitors, immunomodulatory drugs and monoclonal antibodies. Compared to bortezomib- and lenalidomide-based regimens alone, the addition of high-dose melphalan followed by autologous transplantation significantly improves progression-free survival, although an overall survival benefit was not observed in all trials. Moreover, follow up of recent trials is still too short to show any difference in survival. In the light of these findings, novel agent-based induction followed by autologous transplantation is considered the standard upfront treatment for eligible patients (level of evidence: 1A). Post-transplant consolidation and maintenance treatment can further improve patient outcome (1A). The availability of several novel agents has led to the development of multiple combination regimens such as salvage treatment options. In this context, the role of salvage autologous transplantation and allotransplant has not been extensively evaluated. In the case of prolonged remission after upfront autologous transplantation, another autologous transplantation at relapse can be considered (2B). Patients who experience early relapse and/or have high-risk features have a poor prognosis and may be considered as candidates for clinical trials that, in young and fit patients, may also include an allograft in combination with novel agents (2B). Ongoing studies are evaluating the role of novel cellular therapies, such as inclusion of antibody-based triplets and quadruplets, and chimeric antigen receptor-T cells. Despite encouraging preliminary results, longer follow up and larger patient numbers are needed before the clinical use of these novel therapies can be widely recommended.
KW - Journal Article
KW - Multiple Myeloma/therapy
KW - Hematopoietic Stem Cell Transplantation/methods
KW - Immunotherapy, Adoptive/methods
KW - Transplantation, Autologous/methods
KW - Europe
KW - Humans
KW - Salvage Therapy/instrumentation
KW - Treatment Outcome
KW - Practice Guidelines as Topic
U2 - 10.3324/haematol.2017.174573
DO - 10.3324/haematol.2017.174573
M3 - SCORING: Review article
C2 - 29217780
VL - 103
SP - 197
EP - 211
JO - HAEMATOLOGICA
JF - HAEMATOLOGICA
SN - 0390-6078
IS - 2
ER -
