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2017 ; 8
(36
): 60656-60672
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Emerging drugs and combinations to treat multiple myeloma
#MMPMID28948001
Larocca A
; Mina R
; Gay F
; Bringhen S
; Boccadoro M
Oncotarget
2017[Sep]; 8
(36
): 60656-60672
PMID28948001
show ga
In the past few years, multiple targeted therapies and immunotherapies including
second generation immunomodulatory drugs (pomalidomide) and proteasome inhibitors
(carfilzomib, ixazomib), monoclonal antibodies and checkpoint inhibitors were
approved for the treatment of myeloma or entered advanced phases of clinical
testing. These agents showed significant activity in advanced myeloma and
increased the available treatment strategies. Pomalidomide is well-tolerated and
effective in patients with relapsed/refractory multiple myeloma who have
exhausted any possible treatment with lenalidomide and bortezomib. Carfilzomib, a
second-generation proteasome inhibitor, is active as a single agent and in
combination with other anti-myeloma agents. Ixazomib is the first oral proteasome
inhibitor to be evaluated in myeloma and is associated with a good safety profile
and anti-myeloma activity in relapsed/refractory patients, even in those
refractory to bortezomib. Monoclonal antibodies and immune checkpoint inhibitors
are likely to play a major role in the treatment of myeloma over the next decade.
In phase 3 studies, triplet regimens based on these agents combined with a
backbone therapy (including lenalidomide, pomalidomide or bortezomib) were more
efficacious than doublet regimens in patients with relapsed/refractory multiple
myeloma, with limited additional toxic effects. This paper aims to provide an
overview of the recent use of these agents for the treatment of myeloma, in
particular focusing on the role of multi-agent combinations.