Current Treatment Approaches to Newly Diagnosed Multiple Myeloma
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Current Treatment Approaches to Newly Diagnosed Multiple Myeloma. / Ghandili, Susanne; Weisel, Katja C; Bokemeyer, Carsten; Leypoldt, Lisa Beatrice.
In: ONCOL RES TREAT, Vol. 44, No. 12, 16.11.2021, p. 690-699.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - Current Treatment Approaches to Newly Diagnosed Multiple Myeloma
AU - Ghandili, Susanne
AU - Weisel, Katja C
AU - Bokemeyer, Carsten
AU - Leypoldt, Lisa Beatrice
N1 - © 2021 S. Karger AG, Basel.
PY - 2021/11/16
Y1 - 2021/11/16
N2 - BACKGROUND: Multiple myeloma is a so far incurable malignant plasma cell disorder. During the past 2 decades, treatment paradigms substantially changed when novel drugs were introduced initially in treatment of relapsed disease and subsequently also in first-line treatment.SUMMARY: Up to now, first-line treatment differs between patients initially classified as transplant eligible and those who are considered as nontransplant eligible. Transplant-eligible patients receive a primary proteasome inhibitor (PI)-based induction which is being combined with an immunomodulating agent and a CD38-directed monoclonal antibody followed by high-dose melphalan therapy and autologous stem cell transplantation with subsequent maintenance treatment with lenalidomide. Patients who are considered as nontransplant eligible receive upfront treatment preferentially with a continuous combination treatment either with a CD38-directed monoclonal antibody in combination with the immunomodulating agent lenalidomide or a lenalidomide-PI combination followed by lenalidomide maintenance. Key Messages: Primary goal of the initiated treatment is to induce a rapid and deep remission which ideally leads to an eradication of the residual plasma cell clone in sense of a minimal residual disease negativity. Achievement of long-term remission with limited toxicity despite continuous treatment strategies and maintenance or improvement of life-quality is key. Despite successful treatment options, specific difficult-to-treat subgroups, especially patients with high-risk myeloma remain with inferior prognosis and a clear unmet need for novel therapeutic strategies. Future concepts will evaluate cellular treatments and other innovative immunotherapies in first-line treatment in curative intention.
AB - BACKGROUND: Multiple myeloma is a so far incurable malignant plasma cell disorder. During the past 2 decades, treatment paradigms substantially changed when novel drugs were introduced initially in treatment of relapsed disease and subsequently also in first-line treatment.SUMMARY: Up to now, first-line treatment differs between patients initially classified as transplant eligible and those who are considered as nontransplant eligible. Transplant-eligible patients receive a primary proteasome inhibitor (PI)-based induction which is being combined with an immunomodulating agent and a CD38-directed monoclonal antibody followed by high-dose melphalan therapy and autologous stem cell transplantation with subsequent maintenance treatment with lenalidomide. Patients who are considered as nontransplant eligible receive upfront treatment preferentially with a continuous combination treatment either with a CD38-directed monoclonal antibody in combination with the immunomodulating agent lenalidomide or a lenalidomide-PI combination followed by lenalidomide maintenance. Key Messages: Primary goal of the initiated treatment is to induce a rapid and deep remission which ideally leads to an eradication of the residual plasma cell clone in sense of a minimal residual disease negativity. Achievement of long-term remission with limited toxicity despite continuous treatment strategies and maintenance or improvement of life-quality is key. Despite successful treatment options, specific difficult-to-treat subgroups, especially patients with high-risk myeloma remain with inferior prognosis and a clear unmet need for novel therapeutic strategies. Future concepts will evaluate cellular treatments and other innovative immunotherapies in first-line treatment in curative intention.
U2 - 10.1159/000520504
DO - 10.1159/000520504
M3 - SCORING: Review article
C2 - 34784608
VL - 44
SP - 690
EP - 699
JO - ONCOL RES TREAT
JF - ONCOL RES TREAT
SN - 2296-5270
IS - 12
ER -