Introduction: Multiple myeloma therapy has evolved significantly over the past several decades due to the discovery of numerous novel agents. These targeted agents are highly effective but differ in their toxicity profiles. This literature review will highlight the safety of current and emerging myeloma therapy.Areas covered: Therapeutic agents that are reviewed for safety and efficacy data include alkylators, proteasome inhibitors, immunomodulatory agents, monoclonal antibodies, nuclear export inhibitor, and histone deacetylase inhibitor. Emerging studies of BCL2 inhibitors and immune therapies targeting B cell maturation antigen (BCMA) such as CAR T-cell therapies, bispecific antibodies, and antibody-drug conjugates will also be reviewed.Expert opinion: As myeloma therapy continues to evolve, new questions arise such as sequencing of therapy, the role of stem cell transplantation, duration and appropriate choice of maintenance therapy, as well as timing of utilization of immunotherapeutic approaches. Comprehensive understanding of the toxicity profile of these agents is crucial in selecting the best therapy for patients.
Keywords: Multiple myeloma; immune therapies; targeted therapies; therapeutic index; toxicities.