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2016 ; 101
(4
): 396-406
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Treatment of relapsed and refractory multiple myeloma
#MMPMID27033237
Sonneveld P
; Broijl A
Haematologica
2016[Apr]; 101
(4
): 396-406
PMID27033237
show ga
The approach to the patient with relapsed or relapsed/refractory multiple myeloma
(RRMM) requires a careful evaluation of the results of previous treatments, the
toxicities associated with them and an assessment of prognostic factors. Since
the majority of patients will have received prior therapy with drug combinations
including a proteasome inhibitor and/or an immunomodulatory drug (IMiD), it is
the physician's task to choose the right moment for the start of therapy and
define with the patient which goals need to be achieved. The choice of regimen is
usually based on prior responsiveness, drugs already received, prior adverse
effects, the condition of the patient and expected effectiveness and
tolerability. Many double and triple drug combinations are available. In
addition, promising new drugs like pomalidomide, carfilzomib and monoclonal
antibodies are, or will be, available shortly, while other options can be tried
in clinical studies. Finally, supportive care and palliative options need to be
considered in some patients. It is becoming increasingly more important to
consider the therapeutic options for the whole duration of the disease rather
than take a step by step approach, and to develop a systematic approach for each
individual patient.
|Antibodies, Monoclonal/*therapeutic use
[MESH]
|Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
[MESH]
free
free
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