Recent Advances in the Treatment of Patients with Multiple Myeloma
Abstract
:Simple Summary
Abstract
1. Introduction
2. Treatment of Newly Diagnosed Multiple Myeloma
2.1. Front-Line Transplant Setting
2.2. Role of Autologous Stem Cell Transplant (ASCT)
2.3. Post ASCT Treatment: Consolidation and Maintenance
2.4. Front-Line Non-Transplant Setting
3. Treatment of Relapsed Multiple Myeloma
3.1. Treatment of Early Relapse
Second Generation Regimens for Relapsed Refractory Multiple Myeloma (RRMM)
3.2. Late Relapses
4. New Generation Therapies and Future Insights
4.1. Novel Drugs
4.1.1. Selinexor
4.1.2. Melflufen
4.1.3. Iberdomide
4.1.4. Venetoclax
4.2. Immunotherapy
4.2.1. Belantamab Mafodotin
4.2.2. Bispecific Antibodies
4.2.3. CAR-T Cells
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Treatment | No. of Cycles | Post-Induction Response (%) | Post-Consolidation Response (%) | ||||||
---|---|---|---|---|---|---|---|---|---|
Regimen | No. of Patients | Induction/Consolidation | ≥VGPR | ≥CR | s-CR | ≥VGPR | ≥CR | s-CR | Trial Name |
VTd 28 d | 542 | 4/2 | 56 | 9 | 6.5 | 78 | 26 | 20 | CASSIOPEA [16] |
D-VTd 28 d | 543 | 4/2 | 65 | 14 | 7 | 83 | 39 | 29 | |
VRd 21 d | 102 | 4/2 | 57 | 13 | 7 | 73 | 42 | 32 | GRIFFIN [17] |
D-VRd 21 d | 99 | 4/2 | 72 | 19 | 12 | 91 | 51.5 | 42 | |
VRd 21 d | 350 | 3/2 | 47 | - | - | 78 | - | - | IFM 2009 [14] |
VRD 28 d | 458 | 6/2 | 67 | 33 | - | 75.5 | 50 | - | GEM 2012 [15] |
KRd 28 d | 158 | 4/4 | 67 | 34 | 8 | 87 | 62 | 41 | FORTE [18] |
Treatment | No. of Patients | ORR (%) | ≥CR | ≥VGPR | PR | SD | Trial Name |
---|---|---|---|---|---|---|---|
Dara-Rd | 368 | 92.9 | 47.6 | 79.3 | 13.6 | 3 | MAIA [40] |
Rd | 369 | 81.3 | 24.9 | 53.1 | 28.2 | 15.2 | |
Dara-VMP | 350 | 91 | 42.6 | 71.1 | 19.7 | 5.7 | ALCYONE [41] |
VMP | 356 | 74 | 24.4 | 41.1 | 24.2 | 21.3 | |
VRd | 264 | 90.2 | 24.2 | 74.9 | 15.3 | 7 | SWOG S0777 [39] |
Rd | 261 | 78.8 | 12.1 | 53.2 | 25.6 | 16.4 |
Treatment | No. of Patients | Overall Response % | PFS—HR | PFS—Months | OS (Months) | Grade ≥ 3 AE | Median (Range) Prior Lines of Therapy | Trial Name |
---|---|---|---|---|---|---|---|---|
DRd vs. Rd | 569 | 93 vs. 76 | 0.44 | 44.5 vs. 17.5 | NR | 90% vs. 81% | 1 (1−11) | POLLUX [47] |
KRd vs. Rd | 792 | 87 vs. 67 | 0.69 | 26.3 vs. 17.6 | 48.3 vs. 40.4 | 87% vs. 83% | 2 (1−4) | ASPIRE [49] |
EloRd vs. Rd | 646 | 79 vs. 66 | 0.71 | 19.4 vs. 14.9 | 48 vs. 40 | 77% vs. 68% | 2 (1−4) | ELOQUENT 2 [50,51] |
IxaRd vs. Rd | 722 | 78 vs. 72 | 0.74 | 20.6 vs. 14.7 | NR | 74% vs. 69% | 1 (1−3) | TOURMALINE MM1 [52] |
DVd vs. Vd | 498 | 85 vs. 63 | 0.31 | 16.7 vs. 7.1 | NR | NA | 2 (1−9) | CASTOR [56] |
Kd vs. Vd | 929 | 77 vs. 63 | 0.53 | 18.7 vs. 9.4 | 47.8 vs. 38.8 | 82% vs. 71% | 2 (1−2) | ENDEAVOR [55] |
Treatment | No. of Patients | Overall Response % | PFS—HR | PFS—Months | OS—Months | Grade ≥ 3 AE | Median (Range) of Prior Lines of Therapy | Trial Name |
---|---|---|---|---|---|---|---|---|
Isa-Kd vs. Kd | 302 | 87 vs. 83 | 0.53 | NR vs. 19.1 | NR | 77% vs. 67% | 2 (1−4) | IKEMA [63] |
DKd vs. Kd | 466 | 93 vs. 86 | 0.63 | NR vs. 15.8 | NR | 82% vs. 74% | 2 (1−2) | CANDOR [62] |
PVd vs. Vd | 559 | 82 vs. 50 | 0.61 | 11.2 vs. 7.1 | NR | NA | 2 (1−3) | OPTIMISMM [67] |
SelVd vs. Vd | 402 | 76 vs. 62 | 0.7 | 13.9 vs. 9.5 | NR vs. 25 | NA | 1 (1−3) | BOSTON [64] |
PanVd vs. Vd | 768 | 61 vs. 55 | 0.63 | 12 vs. 8 | 33.6 vs. 30.4 | 96% vs. 82% | 1 (1−3) | PANORAMA [65] |
Treatment | No. of Patients | Overall Response % | PFS—HR | PFS—Months | OS—Months | Grade ≥ 3 AE % | Median (Range) of Prior Lines of Therapy | Trial Name |
---|---|---|---|---|---|---|---|---|
IsaPd vs. Pd | 307 | 60 vs. 35 | 0.59 | 11.5 vs. 6.5 | NR | NA | 3 (2−4) | ICARIA [69] |
EloPd vs. Pd | 117 | 53 vs. 26 | 0.54 | 10.3 vs. 4.7 | NR | 57 vs. 60 | 3 (2−8) | ELOQUENT 3 [70] |
DPd | 103 | 66 | NA | 9.9 | 25.1 | 99 | 4 (1−13) | EQUULEUS [71] |
Treatment | No. of Patients | Overall Response % | PFS—Months | OS—Months | Grade ≥ 3 AE | Median (Range) of Prior Lines of Therapy |
---|---|---|---|---|---|---|
KPd [76] | 32 | 50 | 7.2 | 20.6 | 63% | 6 (2−12) |
IxaPd [77] | 31 | 48 | 8.6 | NR | 74% | 2 (1−5) |
PanKd [78] | 30 | 57 | 8 | 23 | 63% | 4 (1−8) |
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Legarda, M.A.; Cejalvo, M.J.; de la Rubia, J. Recent Advances in the Treatment of Patients with Multiple Myeloma. Cancers 2020, 12, 3576. https://doi.org/10.3390/cancers12123576
Legarda MA, Cejalvo MJ, de la Rubia J. Recent Advances in the Treatment of Patients with Multiple Myeloma. Cancers. 2020; 12(12):3576. https://doi.org/10.3390/cancers12123576
Chicago/Turabian StyleLegarda, Mario A., María J. Cejalvo, and Javier de la Rubia. 2020. "Recent Advances in the Treatment of Patients with Multiple Myeloma" Cancers 12, no. 12: 3576. https://doi.org/10.3390/cancers12123576