Targeted therapeutics for multiple myeloma: the arrival of a risk-stratified approach

Rafael Fonseca1, A Keith Stewart

  • 1Mayo Clinic, 13208 East Shea Boulevard, Collaborative Research Building 3-006, Scottsdale, AZ 85259-5494, USA. fonseca.rafael@mayo.edu

Insights

Multiple myeloma (MM) treatment has advanced with novel drugs like immunomodulatory drugs and proteasome inhibitors, improving response rates. However, relapse remains a challenge, necessitating personalized, genetically guided therapies.

Area of Science:

  • Hematology
  • Oncology
  • Pharmacology

Background:

  • Multiple myeloma (MM) is an incurable blood cancer with high relapse rates.
  • Traditional treatments like alkylating agents and corticosteroids were used for decades.
  • Recent advancements include immunomodulatory drugs (thalidomide, lenalidomide) and proteasome inhibitors (bortezomib).

Purpose of the Study:

  • To review the current landscape of multiple myeloma therapeutics.
  • To highlight the impact of novel agents on treatment response rates.
  • To discuss the future of personalized medicine in MM guided by genetic factors.

Main Methods:

  • Review of recent clinical evaluations and therapeutic strategies for MM.
  • Analysis of novel agents including immunomodulatory drugs and proteasome inhibitors.
  • Exploration of targeted therapy approaches based on genetic events.

Main Results:

  • Novel agents have significantly improved response rates in newly diagnosed and relapsed MM.
  • Despite improved responses, universal relapse remains a significant clinical challenge.
  • Pivotal genetic events are identified as key predictors of clinical outcomes.

Conclusions:

  • Further development of broadly active therapeutics is crucial for MM.
  • Targeted therapies addressing specific genetic pathways show promise.
  • Personalized treatment strategies guided by genetic testing and prognostic factors are the future of MM care.

Related Concept Videos

Targeted Cancer Therapies02:57

Targeted Cancer Therapies

The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against specific...
Targeted Cancer Therapies02:57

Targeted Cancer Therapies

The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against specific...
Combination Therapies and Personalized Medicine02:50

Combination Therapies and Personalized Medicine

Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
Combination Therapies and Personalized Medicine02:50

Combination Therapies and Personalized Medicine

Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
Pharmacogenomics: Identification of New Drug Targets01:29

Pharmacogenomics: Identification of New Drug Targets

Advances in genomics have profoundly influenced drug discovery by increasing both the speed and accuracy of pharmaceutical development. Pharmacogenomics, which examines how genetic variation influences drug response, facilitates the identification of novel therapeutic targets and enables patient stratification for personalized treatment. These strategies contribute to improved drug efficacy, minimized adverse effects, and more efficient clinical trial design.Mapping genetic differences...
Treatment Resistent Cancers02:56

Treatment Resistent Cancers

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...