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Multiple myeloma 

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  1. 24-06-2022 | Multiple myeloma | Adis Journal Club | Article
    Targeted Oncology

    Translational Modeling Predicts Efficacious Therapeutic Dosing Range of Teclistamab for Multiple Myeloma

    Objective A first-in-human, Phase I, dose escalation study (MajesTEC-1) is evaluating teclistamab in patients with relapsed/refractory multiple myeloma.

  2. 04-04-2022 | Multiple myeloma | Adis Journal Club | Article
    Oncology and Therapy

    Current Role of Allogeneic Stem Cell Transplantation in Multiple Myeloma

    Buadi & Shaji Kumar Abstract Major progress in the treatment of multiple myeloma has been made in the last several years.

  3. 01-02-2022 | Multiple myeloma | Adis Journal Club | Article
    Oncology and Therapy

    Cellular Immunotherapies for Multiple Myeloma: Current Status, Challenges, and Future Directions

    Chimeric antigen receptor T-cell (CAR T-cell) therapy has been successfully used for the treatment of refractory/relapsed (R/R) Multiple myeloma (MM).

  4. 25-11-2021 | Multiple myeloma | Adis Journal Club | Article
    Clinical Drug Investigation

    Comparative Efficacy of Ciltacabtagene Autoleucel in CARTITUDE-1 vs Physician’s Choice of Therapy in the Long-Term Follow-Up of POLLUX, CASTOR, and EQUULEUS Clinical Trials for the Treatment of Patients with Relapsed or Refractory Multiple Myeloma

    Based on these findings, cilta-cel offers substantial clinical benefits for patients with triple-class exposed relapsed or refractory multiple myeloma.

  5. 05-10-2018 | FDA | News | Article
    approvalsWatch

    NGS test approved for ALL, multiple myeloma residual disease

    Similarly, progression-free and disease-free survival durations were better for multiple myeloma patients with a negative MRD assay than those with a positive finding.

  6. 21-08-2018 | Multiple myeloma | News | Article

    Lenalidomide ‘the best maintenance option’ for newly diagnosed multiple myeloma

    Lenalidomide offers the best overall and progression-free survival among novel agent-based maintenance regimens in patients with newly diagnosed multiple myeloma, according to a systematic review and network meta-analysis.

  7. 04-06-2018 | Multiple myeloma | ASCO 2018 | Article

    Once-weekly carfilzomib shows favorable results for multiple myeloma

    Once-weekly treatment with carfilzomib at the maximum tolerated dose significantly delays disease progression compared with twice-weekly treatment at a lower dose in patients with relapsed or refractory multiple myeloma, study data show.

  8. 04-06-2018 | Multiple myeloma | Highlight | Teaser
    medwireNews@ASCO2018

    Once-weekly carfilzomib shows favorable results for multiple myeloma

    Once-weekly treatment with carfilzomib at the maximum tolerated dose significantly delays disease progression compared with twice-weekly treatment at a lower dose in patients with relapsed or refractory multiple myeloma, study data show.

  9. 09-02-2018 | Multiple myeloma | News | Article

    Selinexor shows efficacy against refractory multiple myeloma

    One in five patients with heavily pretreated, refractory multiple myeloma may respond to treatment with the selective exportin 1 inhibitor selinexor, plus low-dose dexamethasone, phase II study findings indicate.

  10. 26-07-2017 | Teaser

    Transplantation for multiple myeloma

    This article provides an overview of the challenges in the care of patients with relapsed/refractory multiple myeloma, current and emerging treatment options, and the possible role of hematopoietic stem cell transplantation. Summary points Multiple myeloma (MM) is a disorder characterized by accumulation of malignant plasma cells in the bone marrow, hypercalcemia, monoclonal protein, and end organ damage. Newer generation proteasome inhibitors, monoclonal antibodies, and novel agents have been approved for patients with MM, which is increasing the life expectancy of the patients. However, hematopoietic stem cell transplantation still remains the cornerstone of treatment. Approximately 24 hours after completion of the preparative chemotherapy, patients undergoing autologous hematopoietic stem cell transplant (AHSCT) receive a reinfusion of peripheral blood progenitor cells followed by a period of pancytopenia. Red blood cell and platelet transfusions are administered as necessary while hematopoietic colony-stimulating factors are used to speed neutrophil engraftment, which occurs by day 10–11. Platelet counts are expected to recover to >20,000 by day 16. For myeloablative allogeneic hematopoietic stem cell transplant (allo-HSCT) the process is similar to AHSCT but myeloablative transplants require that patients receive high-dose chemotherapy with or without total body radiation, followed by donor stem cell infusion. Non-myeloablative-allogeneic transplantation remains investigational and its role needs to be validated in the era of novel agents. Syngeneic allogeneic transplants are from the identical twin donor and only a limited number of syngeneic transplants have been performed in MM. Transplantation helps in early reduction of clonal diversity and increases the likelihood of cure. Long-term follow-up studies show that AHSCT can achieve profound cytoreduction and cure a portion of patients even before the introduction of novel drugs. Novel immune therapeutic agents such as anti-CD38 antibodies, checkpoint blockade inhibitors, cellular therapies, and vaccines will be available soon and will enhance the anti-myeloma response without transplant-associated risks; such strategies will be complimentary and not a replacement for transplant. Jethava YS & van Rhee F. In:  Plasma Cell Dyscrasias . Edited by Roccaro AM & Ghobrial IM. Springer International Publishing, 2016. doi:10.1007/978-3-319-40320-5_13

  11. 26-07-2017 | Teaser

    Pathology of multiple myeloma

    In this chapter, Manier et al. describe the 'driver' gene alterations involved in the development and progression of multiple myeloma (MM) and discuss the therapeutic implications of a comprehensive understanding of the genomic complexity of MM. Summary points The pathologic diagnosis of multiple myeloma (MM) and other plasma cell proliferative disorders (PCPD) is made on the bone marrow aspirate and biopsy specimen. The goal of the pathologic examination of the bone marrow is to: (a) quantify bone marrow plasma cells (PC); (b) establish PC clonality; (c) distinguish MM from lymphoplasmacytic lymphoma (LPL) and other B-cell lymphomas with plasmacytic differentiation; (d) analyze prognostic factors; (e) detect amyloid deposits; and (f) detect other potential pathologic processes. The standard of care for PC quantification is still morphologic assessment of the bone marrow aspirate and biopsy. Clonality of PCs is inferred by showing of monotypic immunoglobulin light chain expression (kappa or lambda) and/or abnormal patterns of antigen expression. Bone marrow examination helps differentiate LPL from MM. In MM, a monomorphic PC population is usually pure without associated lymphoid component, whereas in LPL small lymphocytes and plasmacytoid lymphocytes typically predominate. The most important laboratory prognostic factors are proliferation rate of neoplastic plasma cells and cytogenetic findings. Amyloid accumulation in extracellular space leads to multiple organ dysfunction; amyloid deposits can be detected in the tissue biopsy using Congo Red stain under polarized light. There is a wide range of pathologic processes that can accompany PCPDs. The most common ones are large granular lymphocyte proliferations and therapy-related myeloid neoplasms. Jevremovic D & Morice W. In: Multiple Myeloma . Edited by Gertz MA & Rajkumar SV. Springer New York, 2014. doi:10.1007/978-1-4614-8520-9_3

  12. 31-01-2018 | Multiple myeloma | News | Article
    guidelinesWatch

    Bone-modifying agent guidelines revised for multiple myeloma

    By Lynda Williams medwireNews is an independent medical news service provided by Springer Healthcare. © 2018 Springer Healthcare part of the Springer Nature group See also:  Treatment-related symptom management in patients with multiple myeloma: a review (journal article) Bone Disease in Multiple Myeloma (book chapter)

  13. 02-01-2018 | Multiple myeloma | News | Article

    Cardiovascular toxicity common with carfilzomib for multiple myeloma

    Carfilzomib is associated with a high rate of clinically significant cardiovascular adverse events in patients with multiple myeloma, show results of a systematic review and meta-analysis.

  14. 16-02-2018 | Multiple myeloma | News | Article

    Denosumab offers alternative to zoledronic acid in multiple myeloma

    Phase III study data show that the RANKL-targeting monoclonal antibody denosumab is noninferior to zoledronic acid for the prevention of bone disease in patients with newly diagnosed multiple myeloma.

  15. 26-07-2017 | Teaser

    Multiple myeloma minimal residual disease

    This chapter reviews the different levels of remission used to define depth of response in myeloma and their clinical significance, as well as the prognostic value and unique characteristics of minimal residual disease detection. Summary points Assessment of minimal residual disease (MRD) is becoming standard diagnostic care for potentially curable neoplasms such as some acute leukemias as well as chronic myeloid and lymphocytic leukemia. Multiple myeloma (MM) remains an incurable disease and no clinical trial has randomized MM patients according to their MRD status in order to investigate the role of MRD to individualize therapy. The experience of several cooperative groups using different MRD techniques has indicated that persistence of MRD is always an adverse prognostic feature. It is thus recommended that it would be safer to take clinical decisions based on MRD-positivity rather than on MRD-negativity, since the patchy pattern of bone marrow (BM) infiltration typically observed in MM leads to a degree of uncertainty regarding MRD-negative results: does this guarantee absence of tumor cells or is it the result of a non-representative BM sample due to patchy tumor infiltration? Many studies have shown the value of MRD to evaluate the efficacy of specific treatment phases and therefore to support potential treatment decisions. Several groups have confirmed the added value of MRD in MM, and the time has come to establish the role of baseline risk factors plus MRD monitoring for tailored therapy. This requires the introduction of standardized, highly sensitive, cost-effective, and broadly available MRD techniques in clinical trials. The choice of MRD technology for monitoring will depend on how individual centers’ priorities adjust to the specific advantages that each tool has to offer. Paiva B, García-Sanz R, & San Miguel JF. In:  Plasma Cell Dyscrasias . Edited by Roccaro AM & Ghobrial IM. Springer International Publishing, 2016. doi:10.1007/978-3-319-40320-5_7

  16. 26-07-2017 | Teaser

    Bone disease in multiple myeloma

    In this chapter Eda et al. discuss the pathogenesis of osteolytic bone disease and focus on advances in our understanding of its biology and therapeutic implications. Summary points Bone involvement represented by osteolytic bone disease (OBD) or osteopenia is one of the pathognomonic and defining characteristic of multiple myeloma (MM). OBD negatively impacts both patients’ quality of life and survival, highlighting the importance of treatment strategies that alleviate OBD in MM. OBD is a consequence of increased osteoclast (OC) activation along with osteoblast (OB) inhibition, resulting in altered bone remodeling; OC number and activity are increased in MM via cytokine deregulation within the bone marrow (BM) milieu. Inhibition of osteolysis and stimulation of OB differentiation leads to reduced tumor growth in vivo. Novel agents targeting OBD are promising therapeutic strategies not only for the treatment of MM OBD but also for the treatment of MM. Several novel agents in addition to bisphosphonates are currently under investigation for their positive effect on bone remodeling via OC inhibition or OB stimulation. Eda H et al. In:  Plasma Cell Dyscrasias . Edited by Roccaro AM & Ghobrial IM. Springer International Publishing, 2016. doi:10.1007/978-3-319-40320-5_14

  17. 26-07-2017 | Teaser

    Risk stratification in multiple myeloma

    Focusing on the Revised International Staging System, the authors here review current prognostic variables and their significance in the staging of multiple myeloma. Summary points Multiple myeloma (MM) remains a highly heterogeneous disease with the overall survival ranging from a few months to decades among different cases. There are many variables that affect risk stratification and prognostic factors in MM can be divided into tumor factors or host factors. Tumor biology factors relate to the MM chromosomal abnormalities, gene expression profile, and tumor burden. Lactate dehydrogenase, plasma cell proliferative rate, extramedullary disease and initial presentation as plasma cell leukemia are additional measures of tumor burden. Host-related factors include age, performance status, and comorbidities. The widely used International Staging System (ISS) does not incorporate genetics, age, and other important variables in its risk stratification. Although it has its own limitations, the recently published Revised International Staging System (R-ISS) that was built upon the framework of ISS, is a more comprehensive and predictive tool for MM patients. Ooi MGM, de Mel S, & Chng WJ. Curr Hematol Malig Rep 2016; 11: 137–147. doi:10.1007/s11899-016-0307-4

  18. 26-07-2017 | Teaser

    Diagnostic advances in multiple myeloma

    This review article summarizes advances in diagnostic testing for multiple myeloma, including detection of monoclonal proteins and imaging techniques to diagnose bone lesions and extramedullary disease. Summary points There have been several advances in the diagnosis of multiple myeloma (MM) in recent years. Serum free light chains (FLC) have improved the ability to diagnose light chain MM; however, there are still difficulties in the serologic diagnosis of MM in some cases, particularly IgA MM. A novel heavy/light chain nephelometric assay (HevyLite) can identify and quantify the M-protein in some of these cases. New evidence supports the use of FLC in bodily fluids such as ascites, pleural effusions, and spinal fluid to diagnose and quantify extramedullary disease. Major advances in diagnostic imaging have changed the International Myeloma Working Group recommendations for the initial evaluation of MM to include whole body low-dose computed tomography, whole body magnetic resonance imaging, and positron emission tomography/computed tomography. Barley K & Chari A. Curr Hematol Malig Rep 2016; 11: 111–117. doi:10.1007/s11899-016-0314-5

  19. 20-03-2018 | Multiple myeloma | Article

    Patient-reported outcomes in relapsed/refractory multiple myeloma: a systematic review

    Sparano F et al. Support Care Cancer 2018; 26: 2075. doi:10.1007/s00520-018-4137-x

  20. 26-07-2017 | Teaser

    Novel induction regimens in multiple myeloma

    The focus of this review is a critical analysis of combinations of novel agents in the treatment of newly diagnosed multiple myeloma in both transplant eligible and ineligible patients. Summary points Multiple myeloma (MM) is the second most common hematologic malignancy, accounting for 1% of neoplastic diseases and 13% of hematologic cancers, and predominantly affects the elderly. The introduction of novel therapies such as thalidomide, lenalidomide, and bortezomib for the treatment of MM in the last 15 years has drastically improved progression-free survival (PFS), overall survival (OS), and quality of life for patients with MM. In transplant-eligible patients, the three-drug regimens CyBorD, RVD, and BiRD appear to be the most effective with tolerable adverse effect profile and PFS benefit. Carfilzomib in combination with lenalidomide and dexamethasone has been shown to induce deep responses to the point of negative minimal residual disease state on flow cytometry. In transplant-ineligible patients, continuous use of two-drug regimens bortezomib/dexamethasone or lenalidomide/dexamethasone has shown superior overall response and PFS with enhanced tolerability compared with three-drug regimens. New agents for the treatment of MM are under investigation in the relapsed or refractory disease state. As these agents are approved and move to the upfront setting, more exciting and promising results for both the transplant eligible and ineligible patient population will be seen. Runcie KD & Mark TM. Curr Hematol Malig Rep 2015; 10: 388–394. doi:10.1007/s11899-015-0282-1

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