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Emerging and current treatment combinations for transplant-ineligible multiple myeloma patients

Paola Tacchetti1, Serena Rocchi1,2, Simona Barbato1

  • 1Irccs Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.

Expert Review of Hematology
|October 4, 2021
PubMed
Abstract

Insights

Novel agents have transformed treatment for newly diagnosed transplant-ineligible multiple myeloma (NDTIMM). Current regimens like VRd, DaraVMP, and DaraRd offer improved outcomes, with ongoing research exploring new therapies and personalized approaches.

Area of Science:

  • Hematology
  • Oncology
  • Clinical Therapeutics

Background:

  • Novel agents have revolutionized treatment for newly diagnosed transplant-ineligible multiple myeloma (NDTIMM).
  • This shift offers enhanced response depth and extended survival for NDTIMM patients.

Purpose of the Study:

  • To review the current treatment landscape for NDTIMM.
  • To discuss potential future treatment developments in NDTIMM.

Main Methods:

  • Review of recent phase III trials and regulatory approvals.
  • Exploration of novel combinations and emerging therapeutic agents.
  • Discussion of personalized treatment paradigms.

Main Results:

  • Bortezomib-lenalidomide-dexamethasone (VRd), daratumumab-bortezomib-melphalan-prednisone (DaraVMP), and daratumumab-lenalidomide-dexamethasone (DaraRd) are new standards of care.
  • These regimens demonstrate superior efficacy compared to previous standards.
  • Ongoing trials investigate quadruplet regimens and second-generation proteasome inhibitors.

Conclusions:

  • The therapeutic landscape for NDTIMM is rapidly evolving with new agents and immunotherapies.
  • Personalized approaches including frailty-adapted, risk-based, and minimal residual disease-driven paradigms are under investigation.
  • Future treatments hold promise for further improving outcomes in NDTIMM.
Keywords:
Elderly patientsimmunomodulatory drugsmonoclonal antibodiesmultiple myelomanewly diagnosednovel agentsproteasome inhibitorstransplant-ineligible

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