Treatment of relapsed and refractory multiple myeloma
Open Access
- 31 March 2016
- journal article
- review article
- Published by Ferrata Storti Foundation (Haematologica) in Haematologica
- Vol. 101 (4), 396-406
- https://doi.org/10.3324/haematol.2015.129189
Abstract
The approach to the patient with relapsed or relapsed/refractory multiple myeloma (RRMM) requires a careful evaluation of the results of previous treatments, the toxicities associated with them and an assessment of prognostic factors. Since the majority of patients will have received prior therapy with drug combinations including a proteasome inhibitor and/or an immunomodulatory drug (IMiD), it is the physician’s task to choose the right moment for the start of therapy and define with the patient which goals need to be achieved. The choice of regimen is usually based on prior responsiveness, drugs already received, prior adverse effects, the condition of the patient and expected effectiveness and tolerability. Many double and triple drug combinations are available. In addition, promising new drugs like pomalidomide, carfilzomib and monoclonal antibodies are, or will be, available shortly, while other options can be tried in clinical studies. Finally, supportive care and palliative options need to be considered in some patients. It is becoming increasingly more important to consider the therapeutic options for the whole duration of the disease rather than take a step by step approach, and to develop a systematic approach for each individual patient.Keywords
This publication has 105 references indexed in Scilit:
- Review of health-related quality of life data in multiple myeloma patients treated with novel agentsLeukemia, 2013
- Risk of progression and survival in multiple myeloma relapsing after therapy with IMiDs and bortezomib: A multicenter international myeloma working group studyLeukemia, 2011
- Impact of lenalidomide dose on progression-free survival in patients with relapsed or refractory multiple myelomaLeukemia, 2011
- Criteria for diagnosis, staging, risk stratification and response assessment of multiple myelomaLeukemia, 2008
- VTD combination therapy with bortezomib–thalidomide–dexamethasone is highly effective in advanced and refractory multiple myelomaLeukemia, 2008
- Combined pegylated liposomal doxorubicin and bortezomib is highly effective in patients with recurrent or refractory multiple myeloma who received prior thalidomide/lenalidomide therapyCancer, 2008
- Lenalidomide plus Dexamethasone for Relapsed Multiple Myeloma in North AmericaNew England Journal of Medicine, 2007
- Lenalidomide plus Dexamethasone for Relapsed or Refractory Multiple MyelomaNew England Journal of Medicine, 2007
- A randomized phase 2 study of lenalidomide therapy for patients with relapsed or relapsed and refractory multiple myelomaBlood, 2006
- Bortezomib or High-Dose Dexamethasone for Relapsed Multiple MyelomaNew England Journal of Medicine, 2005