Second Autologous Hematopoietic Stem Cell Transplant as Salvage Therapy for Relapsed Multiple Myeloma: A Global Treatment Option for Eligible Patients

Gonsalves, Wilson I.; Kansagra, Ankit

doi:10.1159/000486272

Cited by 6 publications

(1 citation statement)

References 6 publications

(8 reference statements)

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“…Nevertheless, absent an OS benefit of front-line ASCT in patients with standard risk disease when compared to RVD followed by lenalidomide maintenance, for example, some investigators and patients prefer to delay ASCT until first relapse, after harvesting and storing stem cells during induction [36,37]. In this setting, salvage ASCT should be systematically considered in patients who have not received a transplant [38][39][40]. One issue is the selection of the optimal re-induction regimen prior to salvage ASCT given upfront as a long-term therapy, especially for patients progressing on lenalidomide.…”

Section: Salvage Asctmentioning

confidence: 99%

Gaps and opportunities in the treatment of relapsed-refractory multiple myeloma: Consensus recommendations of the NCI Multiple Myeloma Steering Committee

et al. 2022

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A wide variety of new therapeutic options for Multiple Myeloma (MM) have recently become available, extending progression-free and overall survival for patients in meaningful ways. However, these treatments are not curative, and patients eventually relapse, necessitating decisions on the appropriate choice of treatment(s) for the next phase of the disease. Additionally, an important subset of MM patients will prove to be refractory to the majority of the available treatments, requiring selection of effective therapies from the remaining options. Immunomodulatory agents (IMiDs), proteasome inhibitors, monoclonal antibodies, and alkylating agents are the major classes of MM therapies, with several options in each class. Patients who are refractory to one agent in a class may be responsive to a related compound or to a drug from a different class. However, rules for selection of alternative treatments in these situations are somewhat empirical and later phase clinical trials to inform those choices are ongoing. To address these issues the NCI Multiple Myeloma Steering Committee formed a relapsed/refractory working group to review optimal treatment choices, timing, and sequencing and provide recommendations. Additional issues considered include the role of salvage autologous stem cell transplantation, risk stratification, targeted approaches for genetic subsets of MM, appropriate clinical trial endpoints, and promising investigational agents. This report summarizes the deliberations of the working group and suggests potential avenues of research to improve the precision, timing, and durability of treatments for Myeloma.

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