Promising therapeutic approaches for relapsed/refractory multiple myeloma

Hematology. 2022 Dec;27(1):343-352. doi: 10.1080/16078454.2022.2045724.

Abstract

Objective: Treatment strategies for relapsed/refractory MM are particularly complex. In particular, patients who are refractory to the three classes of therapies have limited therapeutic options and poor survival. Fortunately, promising treatments are emerging, but their incorporation into existing treatments still needs to be defined. We will describe the latest trends and emerging developments in the field of therapies for RRMM by analyzing the most recent clinical data and new technologies in drug development.

Methods: Pubmed, Embase and Cochrane Library were searched to select eligible studies, the clinical data of new promising treatments were reviewed. The key results of the most recent clinical trial were summarized in Table.

Results: A total of 13 studies were included in the final analysis involving anti-BCMA CAR T-cell therapy, Combined CAR T-cell therapy, antibody-drug conjugates, bispecific Ab therapy and CELMoDs. The key efficacy and side effects of treatments were summarized.

Conclusions: There is great promise for a set of next-generation of rescue therapies, including CAR T-cell therapy, bispecific antibodies, antibody-drug conjugates, and novel PROteolysis Targeting Chimeras. Emerging new treatments for MM provide more choices for relapsed/refractory multiple myeloma (RRMM). The optimal therapy for each patient should be based on disease-related factors, such as previous therapies, duration of response to prior drugs, clinical and biochemical features of relapse, and the relationship of patient comorbidities with known AE profiles of the different therapies.

Keywords: Bromodomain and extra-terminal proteins; CAR NK-cell; CAR T-cell; CELMoDs; PROteolysis Targeting Chimeras; Relapsed/refractory multiple myeloma; antibody–drug conjugates; bispecific antibodies.

Publication types

  • Review

MeSH terms

  • Antibodies, Bispecific* / therapeutic use
  • Humans
  • Immunotherapy, Adoptive / methods
  • Multiple Myeloma* / drug therapy
  • Neoplasm Recurrence, Local / drug therapy

Substances

  • Antibodies, Bispecific