[Multiple myeloma : What has been confirmed in therapy?]

Area of Science:

• Hematology
• Oncology
• Immunology

Background:

• Multiple myeloma (MM) is a bone marrow malignancy of terminally differentiated B cells.
• Symptomatic MM presents with osteolysis, anemia, renal dysfunction, and hypercalcemia, necessitating urgent treatment.
• Current guidelines recommend early treatment initiation based on biomarkers to prevent end-organ damage.

Purpose of the Study:

• To summarize current treatment strategies for multiple myeloma.
• To highlight advancements in managing symptomatic and relapsed multiple myeloma.
• To underscore the impact of novel agents on patient survival.

Main Methods:

• Review of current first-line treatments including proteasome inhibitors and immunomodulation.
• Discussion of high-dose chemotherapy and autologous stem cell transplantation benefits.
• Overview of novel agents approved for relapsed MM and their combination therapies.

Main Results:

• Triple combinations with novel agents significantly prolong progression-free survival.
• Five novel agents (second-generation proteasome inhibitors, monoclonal antibodies, HDAC inhibitor) approved for relapsed MM.
• Median overall survival for MM patients has doubled since 2000.

Conclusions:

• Early intervention and novel therapeutic combinations have dramatically improved MM outcomes.
• Advances in treatment have led to a significant increase in median overall survival.
• Radiotherapy and orthopedic interventions remain crucial for skeletal complications.