Treatment of relapsed and refractory multiple myeloma

Abstract

Ferrata Storti Foundation

Global methylation and promoter-specific methylation of the P16, SOCS-1, E-cadherin, P73 and SHP-1 genes and their expression in patients with multiple myeloma during active disease and remission

“…Patients with MM present with anemia, hypercalcemia, renal impairment and/or bone disease (1,2). Promoter hypermethylation as the mechanism of transcriptional silencing of a number of genes has been demonstrated in samples from the bone marrow and peripheral blood of patients with MM and in MM cell lines, although the published results and their interpretation have been inconsistent (3,4).…”

Encouraging Debut of Immunotherapy In Myeloma

“…Isatuximab shows single-agent activity in relapsed / refractory myeloma (RRMM) [9]. Daratumumab was administered for prolonged periods at moderate to high doses with little or no toxicity, despite the fact that the CD38 molecule is also expressed at lower levels, on a fraction of hematopoietic cells, cerebellar Purkinje cells, liver and lung smooth muscle cells, and insulin-secreting cells of pancreas [1].…”

“…Daratumumab was administered for prolonged periods at moderate to high doses with little or no toxicity, despite the fact that the CD38 molecule is also expressed at lower levels, on a fraction of hematopoietic cells, cerebellar Purkinje cells, liver and lung smooth muscle cells, and insulin-secreting cells of pancreas [1]. SAR650984 is another anti-CD38 antibody which is under investigation in clinical trials [9].…”

Multiple Myeloma: New Perspectives

“…Management of relapsed cases usually depends on the patient's condition, the previous treatment modalities used and the duration of remission [34]. Lines of treatment of relapsed disease include re-treatment with the original agent, the use of other drugs such as cyclophosphamide, melphalan, thalidomide or dexamethasone, and introduction of a second autologous stem cell transplant [35].…”

“…For patients with relapsed disease, bortezomib is the preferred line of treatment. Also, lenalidomide and pomalidomide, which are less toxic thalidomide analogues, are showing a promising effect for treatment of relapsed and refractory cases of MM [34]. Ixazomib is an orally available proteasome inhibitor indicated in combination with lenalidomide and dexamethasone in patients who had received at least one prior therapy.…”