Treatment of relapsed multiple myeloma: Evidence-based recommendations

Ceren Durer; Seren Durer; Sarah Lee; Rajshekhar Chakraborty; Mustafa Nadeem Malik; Abdul Rafae; Muhammad Abu Zar; Ahmad Kamal; Nathaniel Rosko; Christy Samaras; Jason Valent; Chakra Chaulagain; Faiz Anwer

doi:10.1016/j.blre.2019.100616

Treatment of relapsed multiple myeloma: Evidence-based recommendations

Blood Rev. 2020 Jan:39:100616. doi: 10.1016/j.blre.2019.100616. Epub 2019 Aug 31.

Authors

Affiliations

¹ Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.
² Department of Hematology and Medical Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH, USA.
³ Department of Medicine, University of Arizona, Tucson, AZ, USA.
⁴ Department of Medicine, McLaren/Michigan State University, Flint, MI, USA.
⁵ Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
⁶ Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA.
⁷ Department of Hematology and Medical Oncology, Cleveland Clinic, Weston, FL, USA.
⁸ Department of Hematology and Medical Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH, USA. Electronic address: anwerf@ccf.org.

PMID: 31500848
DOI: 10.1016/j.blre.2019.100616

Abstract

The practice of choosing the next best therapy for patients with relapsed and/or refractory multiple myeloma (RRMM) is becoming increasingly complex. There is no clear consensus regarding the best treatment sequence for RRMM. With the approval of novel proteasome inhibitors (ixazomib and carfilzomib), immunomodulatory agents (pomalidomide), monoclonal antibodies (daratumumab and elotuzumab), and other targeted therapies, multiple combination regimens utilizing these agents are being studied with the goal of enhancing disease control, prolonging progression-free survival, and improving overall survival. We, herein, describe a review of FDA-approved regimens for RRMM patients and offer a paradigm in selecting subsequent treatment regimens, focusing on patient specific morbidity, treatment toxicity, and disease-specific characteristics.

Keywords: Evidence-based; Multiple myeloma; Refractory; Relapsed; Treatment.

Publication types

Review

MeSH terms

Evidence-Based Practice / methods*
Humans
Multiple Myeloma / therapy*
Neoplasm Recurrence, Local