10.1158/1078-0432.CCR-16-0625 http://scihub22266oqcxt.onion/10.1158/1078-0432.CCR-16-0625 C5300651!5300651
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Clin+Cancer+Res
2016 ; 22
(22
): 5419-5427
Nephropedia Template TP gab.com Text Twit Text FOAVip Twit Text # English Wikipedia
Progress and Paradigms in Multiple Myeloma
#MMPMID28151709
Anderson KC
Clin Cancer Res
2016[Nov]; 22
(22
): 5419-5427
PMID28151709
show ga
Remarkable progress has been achieved in multiple myeloma, and patient median
survival has been extended 3- to 4-fold. Specifically, there have been 18 newly
approved treatments for multiple myeloma in the past 12 years, including seven in
2015, and the treatment paradigm and patient outcome have been transformed. The
definition of patients benefitting from these therapies has been broadened.
Response criteria now include minimal residual disease (MRD), assessed in bone
marrow by multicolor flow cytometry or sequencing, and by imaging for
extramedullary disease. Initial therapy for transplant candidates is a triplet
incorporating novel therapies-that is, lenalidomide, bortezomib, and
dexamethasone or cyclophosphamide, bortezomib, and dexamethasone. Lenalidomide
maintenance until progression can prolong progression-free and overall survival
in standard-risk multiple myeloma, with incorporation of proteasome inhibitor for
high-risk disease. Studies are evaluating the value of early versus late
transplant and MRD as a therapeutic goal to inform therapy. In nontransplant
patients, triplet therapies are also preferred, with doublet therapy reserved for
frail patients, and maintenance as described above. The availability of
second-generation proteasome inhibitors (carfilzomib and ixazomib),
immunomodulatory drugs (pomalidomide), histone deacetylase inhibitors
(panobinostat), and monoclonal antibodies (elotuzumab and daratumumab) allows for
effective combination therapies of relapsed disease as well. Finally, novel
therapies targeting protein degradation, restoring autologous memory
anti-multiple myeloma immunity, and exploiting genetic vulnerabilities show
promise to improve patient outcome even further. Clin Cancer Res; 22(22);
5419-27. ©2016 AACR SEE ALL ARTICLES IN THIS CCR FOCUS SECTION, "MULTIPLE MYELOMA
MULTIPLYING THERAPIES".
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