Hope Amidst Challenges: Therapies for Relapsed/Refractory Multiple Myeloma

Dear Colleagues,

Despite recent progress, multiple myeloma remains incurable for most patients. While treatment options have expanded and advances in frontline therapy have improved outcomes, they have also introduced new challenges in managing relapsed/refractory disease (RRMM). A major obstacle is the limited global availability of novel therapies, with regulatory delays and high costs contributing to significant disparities in access. Nevertheless, improvements in progression-free survival and overall survival have been achieved over the past decade, driven by the rapid growth in therapeutic classes and combination strategies with the introduction of quadruplet therapy in the frontline, CAR T-cells, bispecific antibodies, and antibody drug conjugates (ADCs) in the relapse setting.

Another key challenge is the interpretation and clinical application of minimal residual disease (MRD). While MRD status effectively stratifies patients by risk of relapse, MRD positivity does not always warrant immediate treatment. Critical questions remain regarding optimal timing for treatment discontinuation in MRD-negative patients and reinitiation upon MRD conversion, highlighting the need for further evidence to guide MRD-driven therapeutic decisions.

For this Special Issue, we invite manuscripts that explore real-world outcomes in patients with RRMM treated with T-cell engagers or antibody-drug conjugates (ADCs). We also welcome studies focused on MRD assessment and response-adapted therapy, particularly those utilizing experimental MRD detection technologies in peripheral blood.

We also welcome systematic reviews, original research, economic evaluations, and cost-effectiveness studies on this relevant topic.

Dr. Martha L. Louzada
Guest Editor

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