An update on novel multiple myeloma targets

ABSTRACT

Introduction

Despite therapeutic progress, leading to a significant improvement of outcome, multiple myeloma (MM) remains a difficult to treat hematologic disease due to its biological heterogeneity and clinical complexity.

Areas covered

Treatment of patients refractory and resistant to all classes of agents used in newly diagnosed MM is becoming a relevant problem for every hematologist. New generation immunotherapies, such as conjugated mAb, bispecific mAbs and CAR-T cells, targeting novel molecules as BCMA, have showed relevant results in very advanced MM. In the same setting, small molecules, such as selinexor and melflufen, also proved to be effective. We are currently waiting for the results of under evaluation personalized therapy, directed against specific gene mutations or signaling pathways, responsible for disease progression.

Expert Opinion

In the near future, many therapeutic strategies will become available for MM and the challenge will be to position each approach in order to cure, maintaining a good quality of life in these patients.

KEYWORDS:

• Multiple myeloma
• monoclonal antibodies
• bispecific antibodies
• antibody-drug conjugates
• CAR T cell therapy
• targets

Article highlights

• Multiple myeloma is an incurable disease and most patients experience one or more relapses that require subsequent treatments

• MM is difficult to treat due to patient- and disease-related heterogeneities

• The treatment of patients who become refractory to the most used drugs as IMiDs, PI and naked mAbs remains the Achilles’ heel of MM management

• During the last two years novel exciting molecules and new immunotherapeutic approaches have been approved and introduced in the armamentarium of MM therapy

• Challenge of the future will be to personalize therapy and to sequence available treatments in the best possible way

Declaration of interest

M Offidani has received honoraria from and served as advisory for AbbVie, Amgen, BMS, Celgene, Janssen, GSK, Sanofi and Takeda. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed

Reviewer disclosures

A peer reviewer on this manuscript is an advisor for Fujmoto Pharmaceutical Corporation, Japan, and has revievied honorarium from Bristol Myers Squibb. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

The paper was not funded.