TY - JOUR
T1 - Treatment of relapsed and refractory multiple myeloma in the era of novel agents
AU - van de Donk, Niels W C J
AU - Lokhorst, Henk M
AU - Dimopoulos, Meletios
AU - Cavo, Michele
AU - Morgan, Gareth
AU - Einsele, Hermann
AU - Kropff, Martin
AU - Schey, Steve
AU - Avet-Loiseau, Hervé
AU - Ludwig, Heinz
AU - Goldschmidt, Hartmut
AU - Sonneveld, Pieter
AU - Johnsen, Hans E
AU - Bladé, Joan
AU - San-Miguel, Jesús F
AU - Palumbo, Antonio
N1 - Copyright © 2010 Elsevier Ltd. All rights reserved.
PY - 2011
Y1 - 2011
N2 - The introduction of the Immunomodulatory drugs (IMiDs) and proteasome inhibitors, used either as a single-agent or combined with classic anti-myeloma therapies, has improved the outcome for patients with relapsed myeloma. However, there is currently no generally accepted standard treatment for relapsed/refractory myeloma patients, partly because of the absence of trials comparing the efficacy of the novel agents in relapsed/refractory myeloma. Choice of a new treatment regimen depends on both patient and disease-specific characteristics. A lenalidomide-based regimen is the first choice in patients with neuropathy, while bortezomib has the highest efficacy in patients with renal insufficiency and is not associated with increased risk of thromboembolism. A second autologous stem cell transplantation (auto-SCT) can be applied in patients with a progression-free period of ⩾18-24months after the first auto-SCT. In high-risk relapse such as occurring early after auto-SCT consolidation with allogeneic SCT can be considered. In this review we provide an overview of the various salvage regimens and give recommendations for treatment of patients with relapsed/refractory myeloma in different clinical settings.
AB - The introduction of the Immunomodulatory drugs (IMiDs) and proteasome inhibitors, used either as a single-agent or combined with classic anti-myeloma therapies, has improved the outcome for patients with relapsed myeloma. However, there is currently no generally accepted standard treatment for relapsed/refractory myeloma patients, partly because of the absence of trials comparing the efficacy of the novel agents in relapsed/refractory myeloma. Choice of a new treatment regimen depends on both patient and disease-specific characteristics. A lenalidomide-based regimen is the first choice in patients with neuropathy, while bortezomib has the highest efficacy in patients with renal insufficiency and is not associated with increased risk of thromboembolism. A second autologous stem cell transplantation (auto-SCT) can be applied in patients with a progression-free period of ⩾18-24months after the first auto-SCT. In high-risk relapse such as occurring early after auto-SCT consolidation with allogeneic SCT can be considered. In this review we provide an overview of the various salvage regimens and give recommendations for treatment of patients with relapsed/refractory myeloma in different clinical settings.
U2 - 10.1016/j.ctrv.2010.08.008
DO - 10.1016/j.ctrv.2010.08.008
M3 - Review article
SN - 0305-7372
VL - 37
SP - 266
EP - 283
JO - Cancer Treatment Reviews
JF - Cancer Treatment Reviews
ER -