Optimizing therapy in bortezomib-exposed patients with multiple myeloma

ABSTRACT

Introduction: Multiple myeloma prognosis has improved significantly during the past decade, with survival prolongation mainly due to the incorporation of novel agents. Bortezomib represents one of the main backbone agents of antimyeloma treatment.

Areas covered: This review aims to identify possible and available therapeutic options for patients who experience disease refractoriness following bortezomib exposure.

Expert commentary: For patients who finally relapse after bortezomib exposure treatment strategy should be individualized. For patients with disease resistant to bortezomib, the combination of lenalidomide-dexamethasone with a monoclonal antibody seems to be the most optimal choice for second-line treatment. For third line, pomalidomide-based regimens can be effective even in bortezomib refractory patients. Several novel agents are currently under investigation in order to treat multi-refractory disease.G

KEYWORDS:

• Bortezomib
• multiple myeloma
• refractoriness
• relapsed disease
• triplet based regimens

Declaration of interest

E Terpos has received honoraria from Amgen, Celgene/Genesis, Janssen, Takeda, and Bristol-Myer Squibb, and has received research support from Amgen, Celgene/Genesis, Janssen, 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.

Peer reviewer disclosures

One peer reviewer has received honoraria, consulting fees, and research funding from Celgene, Amgen, Janssen, Bristol-Myer Squibb, and Takeda. Peer reviewers on this manuscript have no other relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.