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Updated: May 23, 2026

Repression of Multiple Myeloma Cell Growth In Vivo by Single-wall Carbon Nanotube (SWCNT)-delivered MALAT1 Antisense Oligos
Published on: December 13, 2018
Novel therapeutics in multiple myeloma
1Division of Hematology-Oncology, Mayo Clinic in Arizona, 13400 East Shea Boulevard, Scottsdale, AZ, USA. stewart.keith@mayo.edu
Abstract:
Most myeloma patients still experience recurrent relapse and eventually become resistant and/or intolerant of effective agents such as corticosteroids, alkylating agents, immune modulators (lenalidomide and thalidomide) or proteasome inhibitors such as bortezomib. Once this happens average survivals are less than one year. Progress has been made for such patients, however, with the demonstration of clinical benefit of novel proteasome inhibitors (carfilzomib) and immune modulators (pomalidomide). Pomalidomide when used with dexamethasone has activity in 30-60% of patients depending on disease stage. Carfilzomib is an irreversible proteasome inhibitor with favorable toxicity profile (minimal neuropathy) and response rates of 17-54% depending on the disease stage treated. Novel targets are also being explored. Histone deacetylase inhibitors such as vorinostat and panobinostat are in phase II testing although results from a randomized trial combining vorinostat with bortezomib were disappointing. Other small molecules or monoclonal antibodies with novel targets such as kinase inhibitors(AKT, CDK5) and cell surface receptors (e.g. elotuzumab) are undergoing active investigation.
Insights
Newer therapies offer hope for relapsed or refractory multiple myeloma patients. Novel agents like carfilzomib and pomalidomide show clinical benefit, improving outcomes for those resistant to standard treatments.
Area of Science:
- Oncology
- Hematology
- Pharmacology
Background:
- Multiple myeloma frequently relapses, with patients developing resistance to established treatments like corticosteroids, alkylating agents, and initial proteasome inhibitors (bortezomib).
- Limited treatment options and poor prognoses (average survival <1 year) exist for patients with refractory or relapsed multiple myeloma.
Purpose of the Study:
- To review the clinical benefit of novel therapeutic agents for relapsed or refractory multiple myeloma.
- To highlight emerging treatment strategies targeting novel pathways in multiple myeloma.
Main Methods:
- Review of clinical trial data and published literature on novel agents in multiple myeloma.
- Analysis of efficacy and safety profiles of carfilzomib, pomalidomide, and other investigational agents.
Main Results:
- Pomalidomide combined with dexamethasone demonstrates activity in 30-60% of patients.
- Carfilzomib, an irreversible proteasome inhibitor, shows response rates of 17-54% with a favorable toxicity profile.
- Investigational agents including histone deacetylase inhibitors, kinase inhibitors, and monoclonal antibodies are under active exploration.
Conclusions:
- Novel proteasome inhibitors (carfilzomib) and immune modulators (pomalidomide) offer significant clinical benefit for relapsed/refractory multiple myeloma.
- Ongoing research into novel targets and agents holds promise for further improving outcomes in advanced multiple myeloma.
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