A review on the treatment of multiple myeloma with small molecular agents in the past five years

Area of Science:

• Hematology
• Oncology
• Medicinal Chemistry

Background:

• Multiple myeloma (MM) is an incurable plasma cell malignancy with increasing global incidence.
• Current treatments combining proteasome inhibitors and immunomodulatory drugs improve outcomes but often face relapse and drug resistance.
• There is a critical need for novel therapeutic strategies with improved specificity and efficacy.

Purpose of the Study:

• To review emerging small molecular agents for multiple myeloma treatment.
• To detail the target mechanisms, structure-activity relationships, and clinical potential of these agents.
• To highlight the development of highly specific drugs targeting key myeloma pathways.

Main Methods:

• Literature review of preclinical and clinical studies on small molecular agents for multiple myeloma.
• Analysis of drug mechanisms, focusing on targets like Ikaros and Aiolos.
• Examination of structure-activity relationships to understand drug design principles.

Main Results:

• Identification of promising small molecular agents, including iberdomide, with high specificity for targets like Ikaros and Aiolos.
• Evaluation of the efficacy and safety profiles of these agents in preclinical and clinical settings.
• Understanding of how structural modifications influence the activity and selectivity of these drugs.

Conclusions:

• Small molecular agents represent a promising frontier in overcoming resistance in multiple myeloma.
• Targeted therapies like iberdomide offer potential for improved patient outcomes.
• Further research into structure-activity relationships will guide the development of next-generation multiple myeloma therapeutics.