Review Articles
Vol. 17 No. 1 (2025): Review Articles, Original Article, Scientific Letter, Case Reports Letter to the Editor
Guest Editor: Pellegrino Musto HOW FIRST-LINE THERAPY IS CHANGING IN NON-TRANSPLANT ELIGIBLE MULTIPLE MYELOMA PATIENTS.
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: February 27, 2025
1538
Views
1254
Downloads
105
HTML
Authors
Treatment outcomes for patients with multiple myeloma have improved in recent decades thanks to new insights into the biology of the disease and the introduction of new drugs and therapeutic approaches. More than half of patients with multiple myeloma are not eligible for transplantation and for years their treatment has been difficult due to the heterogeneity of this patient group and the lack of treatment options. Recently, attention has focused on the concept of frailty and its quantification in order to adapt the schedule and dosage of treatment to the state of fitness. Modulation of therapy for frailty can reduce side effects and toxicity-related death and define the various successes of therapy. The role of frailty and the development of new tools may provide a way forward to customize the treatment of different patients with multiple myeloma who are not eligible for transplantation. The use of the new association, particularly based on monoclonal antibodies against CD38, showed profound and durable results in terms of progression-free survival and overall survival. Today, these combinations, especially daratumumab-lenalidomide and dexamethasone, represent the “gold standard” of treatment for these patients. The latest quadruplet therapies and cell-directed therapies, including bispecific antibodies and chimeric antigen receptor T-cell (CAR-T) treatment, appear to be very effective and achieve a high rate of negative minimal residual disease. These latter approaches could redefine the population over the age of 65 that is now considered transplant eligible.
Downloads
Download data is not yet available.
Citations
Rajkumar SV, Dimopoulos MA, Palumbo A, Blade J, Merlini G, Mateos MV, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014 Nov;15(12):e538-48. doi: 10.1016/S1470-2045(14)70442-5.
Goel U, Usmani S, Kumar S. Current approaches to management of newly diagnosed multiple myeloma. Am J Hematol. 2022 May;97 Suppl 1:S3-S25. doi: 10.1002/ajh.26512.
Turesson I, Bjorkholm M, Blimark CH, Kristinsson S, Velez R, Landgren O. Rapidly changing myeloma epidemiology in the general population: Increased incidence, older patients, and longer survival. Eur J Haematol. 2018 Apr 20:10.1111/ejh.13083. doi: 10.1111/ejh.13083.
Kumar SK, Dispenzieri A, Lacy MQ, Gertz MA, Buadi FK, Pandey S, et al. Continued improvement in survival in multiple myeloma: changes in early mortality and outcomes in older patients. Leukemia. 2014 May;28(5):1122-8. doi: 10.1038/leu.2013.313.
Puertas B, González-Calle V, Sobejano-Fuertes E, Escalante F, Queizán JA, Bárez A, et al. Novel Agents as Main Drivers for Continued Improvement in Survival in Multiple Myeloma. Cancers (Basel). 2023 Mar 2;15(5):1558. doi: 10.3390/cancers15051558.
Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013 Mar 2;381(9868):752-62. doi: 10.1016/S0140-6736(12)62167-9. Epub 2013 Feb 8. Erratum in: Lancet. 2013 Oct 19;382(9901):1328.
Palumbo A, Bringhen S, Mateos MV, Larocca A, Facon T, Kumar SK, et al. Geriatric assessment predicts survival and toxicities in elderly myeloma patients: an International Myeloma Working Group report. Blood. 2015 Mar 26;125(13):2068-74. doi: 10.1182/blood-2014-12-615187. Epub 2015 Jan 27. Erratum in: Blood. 2016 Mar 3;127(9):1213. Erratum in: Blood. 2016 Mar 3;127(9):1213. doi: 10.1182/blood-2016-01-693390. Erratum in: Blood. 2016 Aug 18;128(7):1020. doi: 10.1182/blood-2016-07-727081.
Usmani SZ, Hoering A, Cavo M, Miguel JS, Goldschimdt H, Hajek R, et al. Clinical predictors of long-term survival in newly diagnosed transplant eligible multiple myeloma - an IMWG Research Project. Blood Cancer J. 2018 Nov 23;8(12):123. doi: 10.1038/s41408-018-0155-7.
Corre J, Perrot A, Hulin C, Caillot D, Stoppa AM, Facon T, et al. Improved survival in multiple myeloma during the 2005-2009 and 2010-2014 periods. Leukemia. 2021 Dec;35(12):3600-3603. doi: 10.1038/s41375-021-01250-0.
Cowan AJ, Green DJ, Kwok M, Lee S, Coffey DG, Holmberg LA, Tuazon S, Gopal AK, Libby EN. Diagnosis and Management of Multiple Myeloma: A Review. JAMA. 2022 Feb 1;327(5):464-477. doi: 10.1001/jama.2022.0003.
Sedrak MS, Freedman RA, Cohen HJ, Muss HB, Jatoi A, Klepin HD, et al. Older adult participation in cancer clinical trials: A systematic review of barriers and interventions. CA Cancer J Clin. 2021 Jan;71(1):78-92. doi: 10.3322/caac.21638.
Sim S, Kalff A, Tuch G, Mollee P, Ho PJ, Harrison S, et al. The importance of frailty assessment in multiple myeloma: a position statement from the Myeloma Scientific Advisory Group to Myeloma Australia. Intern Med J. 2023 May;53(5):819-824. doi: 10.1111/imj.16049.
Miller HL, Sharpley FA. Frail Multiple Myeloma Patients Deserve More Than Just a Score. Hematol Rep. 2023 Feb 21;15(1):151-156. doi: 10.3390/hematolrep15010015.
Doody P, Lord JM, Greig CA, Whittaker AC. Frailty: Pathophysiology, Theoretical and Operational Definition(s), Impact, Prevalence, Management and Prevention, in an Increasingly Economically Developed and Ageing World. Gerontology. 2023;69(8):927-945. doi: 10.1159/000528561. Epub 2022 Dec 7. Erratum in: Gerontology. 2023;69(8):1043-1044. doi: 10.1159/000531470.
Isaacs A, Fiala M, Tuchman S, Wildes TM. A comparison of three different approaches to defining frailty in older patients with multiple myeloma. J Geriatr Oncol. 2020 Mar;11(2):311-315. doi: 10.1016/j.jgo.2019.07.004.
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA; Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56. doi: 10.1093/gerona/56.3.m146.
Pel-Littel RE, Schuurmans MJ, Emmelot-Vonk MH, Verhaar HJ. Frailty: defining and measuring of a concept. J Nutr Health Aging. 2009 Apr;13(4):390-4. doi: 10.1007/s12603-009-0051-8.
Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013 Jun;14(6):392-7. doi: 10.1016/j.jamda.2013.03.022.
Pawlyn C, Khan AM, Freeman CL. Fitness and frailty in myeloma. Hematology Am Soc Hematol Educ Program. 2022 Dec 9;2022(1):337-348. doi: 10.1182/hematology.2022000346.
Kim DH, Rockwood K. Frailty in Older Adults. N Engl J Med. 2024 Aug 8;391(6):538-548. doi: 10.1056/NEJMra2301292.
K. Rockwood e A. Mitnitski, «Frailty in Relation to the Accumulationof Deficits», J. Gerontol. A. Biol. Sci. Med. Sci., vol. 62, fasc. 7, pp. 722-727, lug. 2007, doi: 10.1093/gerona/62.7.722.
Möller MD, Gengenbach L, Graziani G, Greil C, Wäsch R, Engelhardt M. Geriatric assessments and frailty scores in multiple myeloma patients: a needed tool for individualized treatment? Curr Opin Oncol. 2021 Nov 1;33(6):648-657. doi: 10.1097/CCO.0000000000000792.
Larocca A, Cani L, Bertuglia G, Bruno B, Bringhen S. New Strategies for the Treatment of Older Myeloma Patients. Cancers (Basel). 2023 May 10;15(10):2693. doi: 10.3390/cancers15102693.
Gahagan A, Maheshwari S, Rangarajan S, Ubersax C, Tucker A, Harmon C, et al. Evaluating concordance between International Myeloma Working Group (IMWG) frailty score and simplified frailty scale among older adults with multiple myeloma. J Geriatr Oncol. 2024 Nov;15(8):102051. doi:10.1016/j.jgo.2024.102051.
Engelhardt M, Domm AS, Dold SM, Ihorst G, Reinhardt H, Zober A, et al. A concise revised Myeloma Comorbidity Index as a valid prognostic instrument in a large cohort of 801 multiple myeloma patients. Haematologica. 2017 May;102(5):910-921. doi: 10.3324/haematol.2016.162693.
Facon T, Leleu X, Manier S. How I treat multiple myeloma in geriatric patients. Blood. 2024 Jan 18;143(3):224-232. doi: 10.1182/blood.2022017635.
Mian H, Wildes TM, Vij R, Pianko MJ, Major A, Fiala MA. Dynamic frailty risk assessment among older adults with multiple myeloma: A population-based cohort study. Blood Cancer J. 2023 May 10;13(1):76. doi: 10.1038/s41408-023-00843-5.
Li L, Wu M, Yu Z, Niu T. Nutritional Status Indices and Monoclonal Gammopathy of Undetermined Significance Risk in the Elderly Population: Findings from the National Health and Nutrition Examination Survey. Nutrients. 2023 Sep 29;15(19):4210. doi: 10.3390/nu15194210.
Engelhardt M, Ihorst G, Duque-Afonso J, Wedding U, Spät-Schwalbe E, Goede V, Kolb G, Stauder R, Wäsch R. Structured assessment of frailty in multiple myeloma as a paradigm of individualized treatment algorithms in cancer patients at advanced age. Haematologica. 2020 May;105(5):1183-1188. doi: 10.3324/haematol.2019.242958.
Vatic M, von Haehling S, Ebner N. Inflammatory biomarkers of frailty. Exp Gerontol. 2020;133. https://doi.org/10.1016/j.exger.2020.110858
Tasaka T, Asou H, Munker R, Said JW, Berenson J, Vescio RA, Nagai M, Takahara J, Koeffler HP. Methylation of the p16INK4A gene in multiple myeloma. Br J Haematol. 1998 Jun;101(3):558-64. doi: 10.1046/j.1365-2141.1998.00724
Lee K, Nathwani N, Shamunee J, Lindenfeld L, Wong FL, Krishnan A, Armenian S. Telehealth exercise to Improve Physical function and frailty in patients with multiple myeloma treated with autologous hematopoietic Stem cell transplantation (TIPS): protocol of a randomized controlled trial. Trials. 2022 Nov 3;23(1):921. doi: 10.1186/s13063-022-06848-y.
Brown T, Muls A, Pawlyn C, Boyd K, Cruickshank S. The acceptability of using wearable electronic devices to monitor physical activity of patients with Multiple Myeloma undergoing treatment: a systematic review. Clin Hematol Int. 2024 Jul 29;6(3):38-53. doi: 10.46989/001c.121406.
Beer H, Chung H, Harrison SJ, Quach H, Taylor-Marshall R, Jones L, Krishnasamy M. Listening to What Matters Most: Consumer Endorsed Patient Reported Outcome Measures (PROMs) for Use in Multiple Myeloma Clinical Trials: A Descriptive Exploratory Study. Clin Lymphoma Myeloma Leuk. 2023 Jul;23(7):505-514. doi: 10.1016/j.clml.2023.03.008.
Todaro J, Souza PMR, Pietrocola M, Vieira FDC, Amaro NSDS, Bigonha JDG, Oliveira Neto JB, Del Giglio A. Cross-cultural translation and adaptation of Functional Assessment of Cancer Therapy - Multiple Myeloma tool - MM1 and LEU3 - for Portuguese. Einstein (Sao Paulo). 2022 Feb 7;20:eAO4457. doi: 10.31744/einstein_journal/2022AO4457.
Husson O, de Rooij BH, Kieffer J, Oerlemans S, Mols F, Aaronson NK, van der Graaf WTA, van de Poll-Franse LV. The EORTC QLQ-C30 Summary Score as Prognostic Factor for Survival of Patients with Cancer in the "Real-World": Results from the Population-Based PROFILES Registry. Oncologist. 2020 Apr;25(4):e722-e732. doi: 10.1634/theoncologist.2019-0348.
Efficace F, Gaidano G, Petrucci MT, Niscola P, Cottone F, Codeluppi K, Antonioli E, Tafuri A, Larocca A, Potenza L, Fozza C, Pastore D, Rigolin GM, Offidani M, Romano A, Kyriakou C, Cascavilla N, Gozzetti A, Derudas D, Vignetti M, Cavo M. Association of IMWG frailty score with health-related quality of life profile of patients with relapsed refractory multiple myeloma in Italy and the UK: a GIMEMA, multicentre, cross-sectional study. Lancet Healthy Longev. 2022 Sep;3(9):e628-e635. doi: 10.1016/S2666-7568(22)00172-6.
Wang T, Lu Q, Tang L. Assessment tools for patient-reported outcomes in multiple myeloma. Support Care Cancer. 2023 Jun 30;31(7):431. doi: 10.1007/s00520-023-07902-4.
Murugappan MN, King-Kallimanis BL, Bhatnagar V, Kanapuru B, Farley JF, Seifert RD, Stenehjem DD, Chen TY, Horodniceanu EG, Kluetz PG. Patient-reported frailty phenotype (PRFP) vs. International Myeloma Working Group frailty index (IMWG FI) proxy: A comparison between two approaches to measuring frailty. J Geriatr Oncol. 2024 Mar;15(2):101681. doi: 10.1016/j.jgo.2023.101681. Epub 2023 Dec 16.
Ullrich CK, Baker KK, Carpenter PA, Flowers ME, Gooley T, Stevens S, et al. Fatigue in Hematopoietic Cell Transplantation Survivors: Correlates, Care Team Communication, and Patient-Identified Mitigation Strategies Transplant Cell Ther. 2023 Mar;29(3):200.e1-200.e8.
Terpos E, Mikhael J, Hajek R, Chari A, Zweegman S, Lee HC, et al. Management of patients with multiple myeloma beyond the clinical-trial setting: understanding the balance between efficacy, safety and tolerability, and quality of life. Blood Cancer J. 2021 Feb 18;11(2):40. doi: 10.1038/s41408-021-00432-4.
Dimopoulos MA, Moreau P, Terpos E, Mateos MV, Zweegman S, Cook G, et al. Multiple myeloma: EHA-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2021 Mar;32(3):309-322. doi: 10.1016/j.annonc.2020.11.014. Epub 2021 Feb 3. Erratum in: Ann Oncol. 2022 Jan;33(1):117. doi: 10.1016/j.annonc.2021.10.001.
Morè S, Corvatta L, Manieri MV, Olivieri A, Offidani M. Real-world assessment of treatment patterns and outcomes in patients with relapsed-refractory multiple myeloma in an Italian haematological tertiary care centre. Br J Haematol. 2023 May;201(3):432-442. doi: 10.1111/bjh.18658.
Mateos MV, Richardson PG, Schlag R, Khuageva NK, Dimopoulos MA, Shpilberg O, et al. Bortezomib plus melphalan and prednisone compared with melphalan and prednisone in previously untreated multiple myeloma: updated follow-up and impact of subsequent therapy in the phase III VISTA trial. J Clin Oncol. 2010 May 1;28(13):2259-66. doi: 10.1200/JCO.2009.26.0638.
Facon T, Dimopoulos MA, Dispenzieri A, Catalano JV, Belch A, Cavo M, et al Final analysis of survival outcomes in the phase 3 FIRST trial of up-front treatment for multiple myeloma. Blood. 2018 Jan 18;131(3):301-310. doi: 10.1182/blood-2017-07-795047.
Durie BGM, Hoering A, Sexton R, Abidi MH, Epstein J, Rajkumar SV, et al. Longer term follow-up of the randomized phase III trial SWOG S0777: bortezomib, lenalidomide and dexamethasone vs. lenalidomide and dexamethasone in patients (Pts) with previously untreated multiple myeloma without an intent for immediate autologous stem cell transplant (ASCT). Blood Cancer J. 2020 May 11;10(5):53. doi: 10.1038/s41408-020-0311-8.
O'Donnell EK, Laubach JP, Yee AJ, Chen T, Huff CA, Basile FG, et al. A phase 2 study of modified lenalidomide, bortezomib and dexamethasone in transplant-ineligible multiple myeloma. Br J Haematol. 2018 Jul;182(2):222-230. doi: 10.1111/bjh.15261.
Kumar SK, Jacobus SJ, Cohen AD, Weiss M, Callander N, Singh AK, et al. Carfilzomib or bortezomib in combination with lenalidomide and dexamethasone for patients with newly diagnosed multiple myeloma without intention for immediate autologous stem-cell transplantation (ENDURANCE): a multicentre, open-label, phase 3, randomised, controlled trial. Lancet Oncol. 2020 Oct;21(10):1317-1330. doi: 10.1016/S1470-2045(20)30452-6.
Facon T, Venner CP, Bahlis NJ, Offner F, White DJ, Karlin L, Benboubker L, Rigaudeau S, Rodon P, Voog E, Yoon SS, Suzuki K, Shibayama H, Zhang X, Twumasi-Ankrah P, Yung G, Rifkin RM, Moreau P, Lonial S, Kumar SK, Richardson PG, Rajkumar SV. Oral ixazomib, lenalidomide, and dexamethasone for transplant-ineligible patients with newly diagnosed multiple myeloma. Blood. 2021 Jul 1;137(26):3616-3628. doi: 10.1182/blood.2020008787.
Lapietra G, Fazio F, Petrucci MT. Race for the Cure: From the Oldest to the Newest Monoclonal Antibodies for Multiple Myeloma Treatment. Biomolecules. 2022 Aug 19;12(8):1146. doi: 10.3390/biom12081146.
Facon T, Kumar SK, Plesner T, Orlowski RZ, Moreau P, Bahlis N, et al. Daratumumab, lenalidomide, and dexamethasone versus lenalidomide and dexamethasone alone in newly diagnosed multiple myeloma (MAIA): overall survival results from a randomised, open-label, phase 3 trial. Lancet Oncol. 2021 Nov;22(11):1582-1596. doi: 10.1016/S1470-2045(21)00466-6.
Facon T, Cook G, Usmani SZ, Hulin C, Kumar S, Plesner T, et al. Daratumumab plus lenalidomide and dexamethasone in transplant-ineligible newly diagnosed multiple myeloma: frailty subgroup analysis of MAIA. Leukemia. 2022 Apr;36(4):1066-1077. doi: 10.1038/s41375-021-01488-8. Epub 2022 Jan 2.
Mateos MV, Cavo M, Blade J, Dimopoulos MA, Suzuki K, Jakubowiak A,et al. Overall survival with daratumumab, bortezomib, melphalan, and prednisone in newly diagnosed multiple myeloma (ALCYONE): a randomised, open-label, phase 3 trial. Lancet. 2020 Jan 11;395(10218):132-141. doi: 10.1016/S0140-6736(19)32956-3.
Mateos MV, Dimopoulos MA, Cavo M, Suzuki K, Knop S, Doyen C, et al. Daratumumab Plus Bortezomib, Melphalan, and Prednisone Versus Bortezomib, Melphalan, and Prednisone in Transplant-Ineligible Newly Diagnosed Multiple Myeloma: Frailty Subgroup Analysis of ALCYONE. Clin Lymphoma Myeloma Leuk. 2021 Nov;21(11):785-798. doi: 10.1016/j.clml.2021.06.005.
Larocca A, Bonello F, Gaidano G, D'Agostino M, Offidani M, Cascavilla N, et al. Dose/schedule-adjusted Rd-R vs continuous Rd for elderly, intermediate-fit patients with newly diagnosed multiple myeloma. Blood. 2021 Jun 3;137(22):3027-3036. doi: 10.1182/blood.2020009507.
Salomon M, Jérome L, Cyrille H, Kamel L, Carla A, Gian Matteo P, et al. The IFM2017-03 Phase 3 Trial: A Dexamethasone Sparing-Regimen with Daratumumab and Lenalidomide for Frail Patients with Newly Diagnosed Multiple Myeloma. Blood (2024) 144 (Supplement 1): 774.
Chacon A, Leleu X, Bobin A. 30 Years of Improved Survival in Non-Transplant-Eligible Newly Diagnosed Multiple Myeloma. Cancers (Basel). 2023 Mar 23;15(7):1929. doi: 10.3390/cancers15071929.
Zweegman S, Facon T, Hungria V, Bahlis JN, Venner CP, Braunstein M, et al. Phase 3 Randomized Study of Daratumumab (DARA) + Bortezomib, Lenalidomide and Dexamethasone (VRd) Versus Alone in Patients with Transplant-Ineligible Newly Diagnosed Multiple Myeloma or for Whom Transplant Is Not Planned As Initial Therapy: Analysis of Minimal Residual Disease in the Cepheus Trial. ASH 2024.
Facon T, Dimopoulos MA, Leleu XP, Beksac M, Pour L, Hájek R, et al. Isatuximab, Bortezomib, Lenalidomide, and Dexamethasone for Multiple Myeloma. N Engl J Med. 2024 Oct 31;391(17):1597-1609. doi: 10.1056/NEJMoa2400712.
Leleu X, Hulin C, Lambert J, Bobin A, Perrot A, Karlin L, et al. Isatuximab, lenalidomide, dexamethasone and bortezomib in transplant-ineligible multiple myeloma: the randomized phase 3 BENEFIT trial. Nat Med. 2024 Aug;30(8):2235-2241. doi: 10.1038/s41591-024-03050-2. Epub 2024 Jun 3.
Usmani SZ, Mielnik M, Byun JM, Alonso Ar, Abdallah Al-Ola A, Garg M, Quach H, Min C-K, Janowski W, M. Ocio E, Weisel K, Oriol A et al. A phase 1 study of belantamab mafodotin in combination with standard of care in newly diagnosed multiple myeloma: An interim analysis of DREAMM-9. 2023 ASCO Annual Meeting.
Zhang X, Zhang H, Lan H, Wu J, Xiao Y. CAR-T cell therapy in multiple myeloma: Current limitations and potential strategies. Front Immunol. 2023 Feb 20; 14:1101495. doi: 10.3389/fimmu.2023.1101495.
Munshi NC, Anderson LD Jr, Shah N, Madduri D, Berdeja J, Lonial S, et al. Idecabtagene Vicleucel in Relapsed and Refractory Multiple Myeloma. N Engl J Med. 2021 Feb 25;384(8):705-716. doi: 10.1056/NEJMoa2024850.
Berdeja JG, Madduri D, Usmani SZ, Jakubowiak A, Agha M, Cohen AD, et al. Ciltacabtagene autoleucel, a B-cell maturation antigen-directed chimeric antigen receptor T-cell therapy in patients with relapsed or refractory multiple myeloma (CARTITUDE-1): a phase 1b/2 open-label study. Lancet. 2021 Jul 24;398(10297):314-324. doi: 10.1016/S0140-6736(21)00933-8. Epub 2021 Jun 24. Erratum in: Lancet. 2021 Oct 2;398(10307):1216. doi: 10.1016/S0140-6736(21)02132-2.
Lin Y, Qiu L, Usmani S, Joo CW, Costa L, Derman B, et al. Consensus guidelines and recommendations for the management and response assessment of chimeric antigen receptor T-cell therapy in clinical practice for relapsed and refractory multiple myeloma: a report from the International Myeloma Working Group Immunotherapy Committee. Lancet Oncol. 2024 Aug;25(8):e374-e387. doi: 10.1016/S1470-2045(24)00094-9. Epub 2024 May 28. Erratum in: Lancet Oncol. 2024 Aug;25(8):e336. doi: 10.1016/S1470-2045(24)00337-1.
Dytfeld D, Dhakal B, Agha M, Manier S, Delforge M, Kuppens S, et al. Bortezomib, Lenalidomide and Dexamethasone (VRd) Followed By Ciltacabtagene Autoleucel Versus Vrd Followed By Lenalidomide and Dexamethasone (Rd) Maintenance in Patients with Newly Diagnosed Multiple Myeloma Not Intended for Transplant: A Randomized, Phase 3 Study (CARTITUDE-5). Blood (2021) 138 (Supplement 1): 1835.
Kegyes D, Constantinescu C, Vrancken L, Rasche L, Gregoire C, Tigu B, et al. Patient selection for CAR T or BiTE therapy in multiple myeloma: Which treatment for each patient? J Hematol Oncol. 2022 Jun 7;15(1):78. doi: 10.1186/s13045-022-01296-2.
Usmani SZ, Garfall AL, van de Donk NWCJ, Nahi H, San-Miguel JF, Oriol A, et al. Teclistamab, a B-cell maturation antigen × CD3 bispecific antibody, in patients with relapsed or refractory multiple myeloma (MajesTEC-1): a multicentre, open-label, single-arm, phase 1 study. Lancet. 2021 Aug 21;398(10301):665-674. doi: 10.1016/S0140-6736(21)01338-6.
Bahlis NJ, Costello CL, Raje NS, Levy MY, Dholaria B, Solh M, et al. Elranatamab in relapsed or refractory multiple myeloma: the MagnetisMM-1 phase 1 trial. Nat Med. 2023 Oct;29(10):2570-2576. doi: 10.1038/s41591-023-02589-w. Epub 2023 Oct 2.
Chari A, Minnema MC, Berdeja JG, Oriol A, van de Donk NWCJ, Rodríguez-Otero P, et al. Talquetamab, a T-Cell-Redirecting GPRC5D Bispecific Antibody for Multiple Myeloma. N Engl J Med. 2022 Dec 15;387(24):2232-2244. doi: 10.1056/NEJMoa2204591.
Krishnan AY, Manier S, Terpos E, Usmani S, Khan J, Pearson R, et al. MajesTEC-7: A Phase 3, Randomized Study of Teclistamab + Daratumumab + Lenalidomide (Tec-DR) Versus Daratumumab + Lenalidomide + Dexamethasone (DRd) in Patients with Newly Diagnosed Multiple Myeloma Who Are Either Ineligible or Not Intended for Autologous Stem Cell Transplant. Blood (2022) 140 (Supplement 1): 10148–10149.
How to Cite
“Guest Editor: Pellegrino Musto HOW FIRST-LINE THERAPY IS CHANGING IN NON-TRANSPLANT ELIGIBLE MULTIPLE MYELOMA PATIENTS”. (2025) Mediterranean Journal of Hematology and Infectious Diseases, 17(1), p. e2025025. doi:10.4084/MJHID.2025.025.
Copyright (c) 2025 Daniele Derudas
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
