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Updated: Dec 28, 2025

An Organotypic High Throughput System for Characterization of Drug Sensitivity of Primary Multiple Myeloma Cells
Published on: July 15, 2015
Multiple Myeloma: Available Therapies and Causes of Drug Resistance
Vanessa Pinto1,2,3, Rui Bergantim1,2,4,5, Hugo R Caires1,2
1i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal.
Abstract:
Multiple myeloma (MM) is the second most common blood cancer. Treatments for MM include corticosteroids, alkylating agents, anthracyclines, proteasome inhibitors, immunomodulatory drugs, histone deacetylase inhibitors and monoclonal antibodies. Survival outcomes have improved substantially due to the introduction of many of these drugs allied with their rational use. Nonetheless, MM patients successively relapse after one or more treatment regimens or become refractory, mostly due to drug resistance. This review focuses on the main drugs used in MM treatment and on causes of drug resistance, including cytogenetic, genetic and epigenetic alterations, abnormal drug transport and metabolism, dysregulation of apoptosis, autophagy activation and other intracellular signaling pathways, the presence of cancer stem cells, and the tumor microenvironment. Furthermore, we highlight the areas that need to be further clarified in an attempt to identify novel therapeutic targets to counteract drug resistance in MM patients.
Insights
Multiple myeloma (MM) treatments are advancing, but drug resistance remains a challenge. Understanding resistance mechanisms is key to developing new therapies for this common blood cancer.
Area of Science:
- Hematology
- Oncology
- Cancer Research
Background:
- Multiple myeloma (MM) is the second most prevalent blood cancer.
- Current MM treatments include corticosteroids, chemotherapy, proteasome inhibitors, and monoclonal antibodies.
- Survival rates have improved, yet drug resistance leads to relapse and refractoriness.
Purpose of the Study:
- To review current treatments for multiple myeloma.
- To explore the multifaceted causes of drug resistance in MM.
- To identify potential novel therapeutic targets against MM drug resistance.
Main Methods:
- Literature review of MM treatments.
- Analysis of mechanisms contributing to drug resistance.
- Identification of research gaps and future therapeutic strategies.
Main Results:
- MM treatment involves a diverse range of drug classes.
- Drug resistance in MM stems from genetic, epigenetic, transport, metabolic, and cellular factors.
- The tumor microenvironment and cancer stem cells also play roles in resistance.
Conclusions:
- Despite treatment advances, drug resistance is a major obstacle in MM management.
- Further research into resistance mechanisms is crucial for developing effective therapies.
- Identifying new therapeutic targets is essential to overcome drug resistance and improve patient outcomes.
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