Novel Non-Immunologic Agents for Relapsed and Refractory Multiple Myeloma: A Review Article

Cancers

Anthony Lévy¹  Thomas Systchenko¹  Xavier Leleu¹  Cécile Gruchet¹  Stéphanie Guidez¹  Niels Moya¹  Hélène Gardeney¹  Florence Sabirou¹  Laura Cailly¹  Arthur Bobin¹  Mathilde Vonfeld¹  Laly Nsiala Makunza¹ 

[1] Department of Hematology, CIC 1402, University Hospital, 86000 Poitiers, France;

关键词: multiple myeloma;    non-immunologic agents;    relapsed or refractory;    IMiDs;    proteasome inhibitors;    XPO1 inhibitors;   

DOI  :  10.3390/cancers13205210

来源: DOAJ

【 摘 要 】

Novel treatments are needed to address the lack of options for patients with relapsed or refractory multiple myeloma. Even though immunotherapy-based treatments have revolutionized the field in recent years, offering new opportunities for patients, there is still no curative therapy. Thus, non-immunologic agents, which have proven effective for decades, are still central to the treatment of multiple myeloma, especially for advanced disease. Building on their efficacy in myeloma, the development of proteasome inhibitors and immunomodulatory drugs has been pursued, and has led to the emergence of a novel generation of agents (e.g., carfilzomib, ixazomib, pomalidomide). The use of alkylating agents is decreasing in most treatment regimens, but melflufen, a peptide-conjugated alkylator with a completely new mechanism of action, offers interesting opportunities. Moreover, with the identification of novel targets, new drug classes have entered the myeloma armamentarium, such as XPO1 inhibitors (selinexor), HDAC inhibitors (panobinostat), and anti-BCL-2 agents (venetoclax). New pathways are still being explored, especially the possibility of a mutation-driven strategy, as biomarkers and targeted treatments are increasing. Though multiple myeloma is still considered incurable, the treatment options are expanding and are progressively becoming more diverse, largely because of the continuous development of non-immunologic agents.

【 授权许可】

Unknown