Current and emerging treatment options for patients with relapsed myeloma

Roberto Castelli, Roberta Gualtierotti, Nicola Orofino, Agnese Losurdo, Sara Gandolfi, Massimo Cugno

Research output: Contribution to journalArticle

Abstract

Multiple myeloma (MM) is a neoplastic disorder. It results from proliferation of clonal plasma cells in bone marrow with production of monoclonal proteins, which are detectable in serum or urine. MM is clinically characterized by destructive bone lesions, anemia, hypercalcemia and renal insufficiency. Its prognosis is severe, with a median survival after diagnosis of approximately 3 years due to frequent relapses. Treatments for patients with relapsed/refractory MM include hematopoietic cell transplantation, a rechallenge using a previous chemotherapy regimen or a trial of a new regimen. The introduction of new drugs such as thalidomide, lenalidomide and bortezomib has markedly improved MM outcomes. When relapse occurs, the clinician's challenge is to select the optimal treatment for each patient while balancing efficacy and toxicity. Patients with indolent relapse can be first treated with a 2-drug or a 3-drug combination. Patients with more aggressive relapse often require therapy with a combination of multiple active agents. Autologous stem cell transplantation should be considered as salvage therapy at first relapse for patients who have cryopreserved stem cells early in the disease course. The aim of this review is to provide an overview on the pharmacological and molecular action of treatments used for patients with relapsed/refractory multiple myeloma.

Original languageEnglish
Pages (from-to)209-219
Number of pages11
JournalClinical Medicine Insights: Oncology
Volume7
DOIs
Publication statusPublished - Aug 19 2013

Keywords

  • Chemotherapy
  • Immunomodulatory drugs (IMIDs)
  • Proteasome inhibitors
  • Relapsed/refractory multiple myeloma

ASJC Scopus subject areas

  • Oncology

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