Gaps and opportunities in the treatment of relapsed-refractory multiple myeloma: Consensus recommendations of the NCI Multiple Myeloma Steering Committee Review
| Authors: | Kumar, S.; Baizer, L.; Callander, N. S.; Giralt, S. A.; Hillengass, J.; Freidlin, B.; Hoering, A.; Richardson, P. G.; Schwartz, E. I.; Reiman, A.; Lentzsch, S.; McCarthy, P. L.; Jagannath, S.; Yee, A. J.; Little, R. F.; Raje, N. S. |
| Review Title: | Gaps and opportunities in the treatment of relapsed-refractory multiple myeloma: Consensus recommendations of the NCI Multiple Myeloma Steering Committee |
| Abstract: | A wide variety of new therapeutic options for Multiple Myeloma (MM) have recently become available, extending progression-free and overall survival for patients in meaningful ways. However, these treatments are not curative, and patients eventually relapse, necessitating decisions on the appropriate choice of treatment(s) for the next phase of the disease. Additionally, an important subset of MM patients will prove to be refractory to the majority of the available treatments, requiring selection of effective therapies from the remaining options. Immunomodulatory agents (IMiDs), proteasome inhibitors, monoclonal antibodies, and alkylating agents are the major classes of MM therapies, with several options in each class. Patients who are refractory to one agent in a class may be responsive to a related compound or to a drug from a different class. However, rules for selection of alternative treatments in these situations are somewhat empirical and later phase clinical trials to inform those choices are ongoing. To address these issues the NCI Multiple Myeloma Steering Committee formed a relapsed/refractory working group to review optimal treatment choices, timing, and sequencing and provide recommendations. Additional issues considered include the role of salvage autologous stem cell transplantation, risk stratification, targeted approaches for genetic subsets of MM, appropriate clinical trial endpoints, and promising investigational agents. This report summarizes the deliberations of the working group and suggests potential avenues of research to improve the precision, timing, and durability of treatments for Myeloma. © 2022, This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply. |
| Keywords: | treatment response; sequence analysis; lenalidomide; clinical trial; review; cancer recurrence; salvage therapy; drug efficacy; genetic analysis; treatment indication; protein bcl 2; cancer immunotherapy; consensus; bortezomib; proteasome inhibitor; multiple myeloma; neoplasm recurrence, local; relapse; alkylating agent; cyclophosphamide; dexamethasone; autologous stem cell transplantation; hematopoietic stem cell transplantation; cancer therapy; risk assessment; cancer resistance; monoclonal antibody; tumor recurrence; genetic susceptibility; immunomodulating agent; drug therapy; transplantation, autologous; retreatment; vulnerable population; randomized controlled trial (topic); clinical trial (topic); study design; molecularly targeted therapy; phase 2 clinical trial (topic); phase 3 clinical trial (topic); autotransplantation; humans; human; b cell maturation antigen; daratumumab; selinexor |
| Journal Title: | Blood Cancer Journal |
| Volume: | 12 |
| Issue: | 6 |
| ISSN: | 2044-5385 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2022-06-29 |
| Start Page: | 98 |
| Language: | English |
| DOI: | 10.1038/s41408-022-00695-5 |
| PUBMED: | 35768410 |
| PROVIDER: | scopus |
| PMCID: | PMC9243011 |
| DOI/URL: | |
| Notes: | Review -- Export Date: 1 August 2022 -- Source: Scopus |
