Article Details - Overview

Upon completion of this educational activity, you should be able to:

• Assess the efficacy and safety of induction therapy with regimens comprising an immunomodulatory agent and/or proteasome inhibitor followed by maintenance therapy in elderly patients with newly diagnosed MM
• Assess the efficacy of a proteasome inhibitor plus a glucocorticoid as induction therapy in newly diagnosed MM
• Compare the efficacy and safety of consolidation using a therapeutic regimen containing an immunomodulatory agent with high-dose chemotherapy/autologous stem cell transplantation after induction therapy in newly diagnosed MM
• Compare the efficacy of induction with conventional chemotherapy with or without an immunomodulatory agent followed by maintenance therapy in elderly patients with newly diagnosed MM
• Evaluate the efficacy and safety of a second-generation proteasome inhibitor in relapsed/refractory MM
• Assess the safety and efficacy of a novel immunomodulatory agent in relapsed/refractory MM
• Evaluate the efficacy and safety of combining an HSP90 inhibitor with a proteasome inhibitor in relapsed/refractory MM
• Assess the feasibility of combining an anti-CS1 MoAb with an immunomodulatory agent or proteasome inhibitor in relapsed/refractory MM

Authors

Medical writer: Aarati Ranganathan, PhD; Medical writer: Bing-e Xu, PhD; Reviewed by: Sagar Lonial, MD

Overview and Purpose

Targeted agents such as immunomodulators and proteasome inhibitors have revolutionized treatment for patients with multiple myeloma (MM) in both newly diagnosed and relapsed/refractory disease, which has resulted in improved survival outcomes. The superior response rates attained in this era of targeted agents has led to a reevaluation of the role and timing of transplantation in the management of MM. Multitargeted agent/chemotherapy combinations, including novel doublets, triplets, and quadruplets, are under active investigation, and phase III trials are reporting favorable progression-free survival results. New methods to prolong response duration and increase the depth and quality of response include application of consolidation and maintenance therapies. These approaches are being evaluated in transplantation-ineligible patients with newly diagnosed MM and in transplantation-eligible patients following induction therapy or subsequent to stem cell support. Despite current advances, however, MM remains an incurable disease, and treatment of patients whose MM has become refractory to currently approved immunomodulators and/or proteasome inhibitors can be challenging. Fortunately, second-generation immunomodulators and proteasome inhibitors are proving to be effective in early trials in this setting. Moreover, a number of emerging agents, including heat shock protein (HSP)90 inhibitors and therapeutic monoclonal antibodies (MoAbs), are yielding synergistic activity with currently approved agents in relapsed/refractory MM.

The purpose of this activity is to update physicians on emerging approaches and novel regimens impacting the current management of frontline MM, including discussion of investigational drugs that yield single-agent and/or synergistic activity in heavily pretreated patients.  

Target Audience

This educational activity is intended for medical oncologists and hematologists involved in the care of patients with MM. No specific skills or knowledge other than a basic training in oncology is required for successful participation in this activity.