[Novel therapeutic approaches for multiple myeloma]

Area of Science:

• Hematology
• Oncology
• Immunotherapy

Background:

• Multiple myeloma treatment traditionally relies on immunomodulatory drugs, proteasome inhibitors, and anti-CD38 antibodies.
• Emergence of T-cell redirection therapies, including CAR-T cell therapy and bispecific antibodies, targeting B-cell maturation antigen (BCMA) marks a significant advancement.

Purpose of the Study:

• To review the current landscape of multiple myeloma treatments, focusing on novel therapeutic modalities.
• To discuss the clinical application and challenges of sequencing new therapies with conventional treatments.

Main Methods:

• Review of current clinical practices and emerging therapeutic strategies for multiple myeloma.
• Analysis of treatment indications for CAR-T cell therapy and bispecific antibodies in Japan.
• Evaluation of efficacy for antibody-drug conjugates and novel targets like GPRC5D.

Main Results:

• CAR-T cell therapy and bispecific antibodies targeting BCMA are indicated as third-line treatments in Japan.
• Combinations of BCMA-targeted antibody-drug conjugates with existing drugs show efficacy.
• GPRC5D is an emerging target for new bispecific antibody therapies.

Conclusions:

• Novel therapies targeting BCMA and GPRC5D have significantly expanded treatment options for multiple myeloma.
• Despite high efficacy, these advanced treatments are not curative.
• Optimizing the sequence of conventional and novel therapies is a critical challenge for improving long-term multiple myeloma management.