First-line Therapy in Newly Diagnosed Multiple Myeloma.

Area of Science:

• Hematology
• Oncology
• Immunotherapy

Background:

• Multiple myeloma treatment has evolved significantly, moving from older regimens to complex quadruplet therapies.
• Current multiple myeloma treatment paradigms often involve indefinite therapy, despite advances.

Purpose of the Study:

• To review current risk stratification and therapeutic approaches for newly diagnosed multiple myeloma.
• To highlight emerging measurable residual disease-adaptive strategies and novel immunotherapies.
• To discuss the integration of chimeric antigen receptor T cells and bispecific antibodies in upfront treatment.

Main Methods:

• Review of current literature on multiple myeloma treatment strategies.
• Analysis of risk stratification methods and measurable residual disease-adaptive approaches.
• Evaluation of novel immunotherapies, including CAR T-cells and bispecific antibodies.

Main Results:

• Quadruplet regimens and autologous stem cell transplantation have significantly improved survival in multiple myeloma.
• Measurable residual disease-adaptive strategies are emerging as key components of optimized therapy.
• Novel immunotherapies show promise for achieving durable remissions and potential functional cures.

Conclusions:

• Personalized treatment approaches informed by disease biology and response are crucial for multiple myeloma management.
• Emerging immunotherapies and adaptive strategies are shifting the paradigm towards treatment-free remissions and functional cures.
• Ongoing research focuses on tailoring therapy to balance efficacy, toxicity, and long-term survivorship.