Updates in the Treatment of Multiple Myeloma

Presenter: Shaji K. Kumar

For patients with newly diagnosed multiple myeloma (MM), treatment with 4-drug regimens produce deep responses and should be considered for those with high-risk features. Daratumumab + lenalidomide and dexamethasone is standard treatment for newly diagnosed patients not eligible for autologous stem cell transplantation (ASCT). Although lenalidomide remains standard maintenance therapy, in some instances more intensive regimens can be considered. ASCT is more effective when given up-front rather than delayed, but delaying transplantation until disease progression is acceptable. CAR T-cell therapy can provide durable responses, and 2 agents are now FDA-approved for use in multiple myeloma. Bispecific T-cell engagers are also effective for relapsed myeloma, as is the BCL2 inhibitor venetoclax, especially for patients with t(11;14) disease. An emerging novel class of drugs, the CELMoDs (cereblon E3 ligase modulator), target cereblon.

Disclosures: Dr. Kumar has disclosed serving as a scientific advisor for and receiving grant/research support from AbbVie, Inc. Amgen Inc., Bristol-Myers Squibb, GlaxoSmithKline, Janssen Pharmaceutica Products, LP, Karyopharm Therapeutics, Regeneron Pharmaceuticals, Inc., Roche Laboratories, Inc., sanofi-aventis U.S., and Takeda Pharmaceuticals North America, Inc.; and receiving honoraria from BeiGene.

Correspondence: Shaji K. Kumar, MD, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. Email: kumar.shaji@mayo.edu
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