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Real-world experience of novel multiple myeloma treatments in a large, single-center cohort in Finland.

In this single-center study, we aimed to describe the characteristics, treatment patterns, and outcomes of patients with multiple myeloma (MM) following treatment with bortezomib, carfilzomib, daratumumab, ixazomib, lenalidomide or pomalidomide-based regimens. Data were collected retrospectively from a study cohort of patients receiving a MM treatment in the Hospital District of Helsinki and Uusimaa (HUS) in Finland between 2016-2020. In total, 472 patients were included in the study. Median age was 68.2 years and nearly 25% had a high cytogenetic risk according to the International Myeloma Wo

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… *Includes 64 lines with VRd, 21 with VMP, 20 with VTd, 15 with VCd, and 7 with other triplets. … | | Novel (N=373) | | | | Most novel (N=67) | | | | | | | ASCT (N=15) | KRd (N=25) | Kd (N=16) | DVd (N=3) | DRd (N=7) | IRd (N=4) | Pd (N=4) | Pom triplets (N=8) | Vd (N=20) | Bor triplets (N=127)* | Rd (N=151) | Other novel (N=8) | Non‐novel (N=42) | Total (N=430) Age (y), Median (Q1, …

Navigating the treatment landscape in multiple myeloma: which combinations to use and when?

Multiple myeloma is one of the most common hematological malignancies, affecting mainly elderly patients. The treatment landscape for the management of this disease has evolved significantly over the past 15 years, and a vast array of therapeutics is now available, including immunomodulatory drugs, proteasome inhibitors, histone deacetylase inhibitors, and monoclonal antibodies. As a result, deciding which drugs to use and when, and whether these should be used in a particular order or combination, can be challenging. Although combination regimens are often associated with deeper responses and

Multiple myeloma: challenges with deciding the optimal sequencing strategy.

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Quadruplet regimen for newly diagnosed multiple myeloma is effective in the standard-risk subgroup but not in the high-risk subgroup.

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Attrition Rates in Multiple Myeloma Treatment under Real World Conditions-An Analysis from the Austrian Myeloma Registry (AMR).

Multiple myeloma (MM) is characterized by serial relapses, necessitating the application of sequential lines of therapy (LoT). Reports on attrition rates (ARs) vary widely. The present study analysed ARs from the Austrian Myeloma Registry. Attrition was defined as being either deceased, progressive without having received another LoT, or lack of follow-up for ≥5 years. A total of 571 patients diagnosed between January 2009 and August 2021 were included (median age: 72 years; median follow-up: 50.8 months). Some 507 patients received at least one LoT. Of the total, 43.6% underwent autologous st

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… The use of triplet treatments positively influenced follow-up (52.8 months, 26.8–96.7 months, vs. 44.5 months, 20–87.6 months; p = 0.033). … The use of triplets is more dominant in transplant-eligible patients in accordance with Kumar et al. [ 15 ]. The effect of triplets on the AR has not been demonstrated, yet a greater chance of deeper remission is seen in our data, which is in agreement with Yong et al. [ 4 ]. …

Molecular Targeting of the BRAF Proto-Oncogene/Mitogen-Activated Protein Kinase (MAPK) Pathway across Cancers.

The mitogen-activated protein kinase (MAPK) pathway is essential for cellular proliferation, growth, and survival. Constitutive activation of this pathway by BRAF mutations can cause downstream activation of kinases, leading to uncontrolled cellular growth and carcinogenesis. Therefore, inhibition of BRAF and the downstream substrate MEK has been shown to be effective in controlling tumor growth and proliferation. Over the last decade, several BRAF and MEK inhibitors have been investigated, ranging from primarily melanoma to various cancer types with BRAF alterations. This subsequently led to

A Comparative Study of Autologous Stem Cell Transplantation (ASCT) Versus No ASCT in Newly Diagnosed Multiple Myeloma: A Single-Institution Experience From South India.

Background Multiple myeloma (MM) is a clonal plasma cell malignancy with significant morbidity and mortality. Autologous stem cell transplantation (ASCT) has been a cornerstone in the treatment of newly diagnosed MM, but its role in the era of novel therapeutic agents remains under evaluation. Data from Indian populations are limited, particularly in the context of ASCT outcomes. This study aimed to compare the outcomes of ASCT versus no ASCT in newly diagnosed MM patients treated at a single institution in South India. Methodology A retrospective analysis was conducted among 59 patients diagn

Balancing the Risk of Cardiotoxicity Outcomes in Treatment Selection for Multiple Myeloma: A Retrospective Multicenter Evaluation of Ixazomib, Lenalidomide, and Dexamethasone (IRd) Versus Carfilzomib, Lenalidomide, and Dexamethasone (KRd).

IntroductionCarfilzomib use has been extensively associated with cardiovascular toxicity; the risk with ixazomib, a novel oral proteasome inhibitor, is underreported and no large comparative analysis is available.MethodsWe conducted a retrospective cohort study utilizing the TriNetX platform to compare toxicity outcomes among multiple myeloma patients who received lenalidomide, dexamethasone, and ixazomib (IRd) or carfilzomib (KRd).ResultsAfter propensity-score-matching 478 patients from each cohort, the onset of new heart failure (HR 0.25; p p = 0.014) at 6 months were significantly lower wit

Moving Toward Continuous Therapy in Multiple Myeloma.

The introduction of novel agents, characterized by favorable toxicity profiles and higher manageability compared to conventional drugs employed in the past, has considerably changed the treatment paradigm for multiple myeloma. Continuous therapy currently represents the standard approach for myeloma patients both at diagnosis and at relapse. In younger patients, long-term maintenance after autologous transplantation significantly improved progression-free survival and overall survival compared to observation. Also in transplant-ineligible patients, continuous treatment with combinations of new

Comprehensive view on chemotherapy-free management of acute myeloid leukemia by using venetoclax in combination with targeted and/or immune therapies.

A hallmark of cancer biology is resistance to apoptosis. BCL-2 is an anti-apoptotic molecule that is being overexpressed in several myeloid diseases, such as acute myeloid leukemia and myelodysplastic syndromes, but also in several lymphoid cancers, such as acute lymphoblastic leukemia, chronic lymphocytic leukemia, non-Hodgkin lymphomas and multiple myeloma. Venetoclax (VEN) is a BCL-2 small molecule inhibitor. Data about its structure, biochemical characteristics and in vitro efficacy against several blood cancer cell lines were first reported in 2013. Shortly after, the first clinical trial

Second Primary Malignancies Post Autologous Stem-cell Transplant in Multiple Myeloma from India - Knowing the Unknown.

To evaluate the incidence, clinical characteristics and outcomes of second primary malignancies (SPM) in Multiple myeloma patients post autologous stem-cell transplant (ASCT). This is a report of myeloma patients from a prospectively maintained database who underwent ASCT between 1st March, 2007 to 31st December, 2022. Baseline characteristics, details of induction, transplant and post-transplant maintenance therapy of these patients were retrieved. Details of treatment received for SPM, and outcomes were also obtained. In total,178 patients underwent 192 ASCTs (14 patients with two ASCTs). Of

Reporting of Postprotocol Therapies and Attrition in Multiple Myeloma Randomized Clinical Trials: A Systematic Review.

ImportanceA thorough understanding of the optimal role and sequence of agents for treatment of multiple myeloma (MM) requires knowledge of the use and rate of postprotocol therapies in randomized clinical trials (RCTs).ObjectivesTo examine the proportion of MM RCTs that reported postprotocol therapies and, among those, the percentage of patients who received no further therapy and how treatments differed between the control and intervention arms.Evidence reviewThe reporting of postprotocol therapies was systematically assessed in published MM RCTs using 3 databases (PubMed, Embase, and Cochran

Diagnostic and Therapeutic Challenges in the Management of Intermediate and Frail Elderly Multiple Myeloma Patients.

Multiple myeloma (MM) mostly affects elderly patients, which represent a highly heterogeneous population. Indeed, comorbidities, frailty status and functional reserve may vary considerably among patients with similar chronological age. For this reason, the choice of treatment goals and intensity is particularly challenging in elderly patients, and it requires a multidimensional evaluation of the patients and the disease. In recent years, different tools to detect patient frailty have been developed, and the International Myeloma Working Group frailty score currently represents the gold standar

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… Some evidence suggested that frail patients might benefit more from two-drug regimens than from full-dose triplets. … The triplet daratumumab, ixazomib and low-dose dexamethasone is currently under evaluation in a phase I/II trial on intermediate-fit and frail patients. …

Multiple Myeloma: Risk Stratification and Toxicity Management

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… Ongoing trials are comparing these effective triplets, studying VRd in combination with monoclonal antibodies, and asking whether VRd can delay the need for transplant, she added. … The National Comprehensive Cancer Network has listed a number of triplets as its preferred regimens for relapsed disease, and one doublet, carfilzomib/dexamethasone. …

Spotlight on quetiapine in bipolar depression.

Because of its relapsing-remitting nature, patients with multiple myeloma [1,2] require extended therapy with chemotherapy, novel agents, autologous stem cell transplants (ASCT), monoclonal antibodies and/or immune therapies for optimal outcomes. Attrition during treatment can negatively impact long-term outcomes and factors influencing the same may be important clues to achieve optimal patient outcomes. This study aims to examine attrition rates and the factors influencing them.We analysed 244 consecutive newly diagnosed patients of multiple myeloma from January 2017 to December 2017 register

Insights on Multiple Myeloma Treatment Strategies.

The introduction of new agents and management strategies over the past decade has resulted in a major step change in treatment outcomes with deepening responses and increased survival for patients with multiple myeloma. In daily clinical practice, healthcare professionals are now faced with challenges including, optimal treatment sequencing and changing treatment goals. In light of this, a group of experts met to discuss diagnostic and treatment guidelines, examine current clinical practice, and consider how new clinical trial data may be integrated into the management of multiple myeloma in t

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… Triplets based on a PI plus an immunomodulatory drugs (IMiD) are the preferable option. Bortezomib-based triplet therapies are the current standard of care. … Triplet combination regimens appear to be superior to doublets in terms of prolonging PFS and 2-drug regimens are not recommended for high-risk patients if triplet combinations are available. …

Autologous Stem Cell Transplantation in Multiple Myeloma: Where Are We and Where Do We Want to Go?

The introduction of high-dose therapy in the 1990s as well as the development of drugs such as thalidomide, lenalidomide, and bortezomib in the 2000s led to an impressive improvement in outcome of patients with multiple myeloma (MM) eligible for autologous stem cell transplantation (ASCT). Clinical trials conducted in the first ten years of the twenty-first century established as standard therapy for these patients a therapeutic approach including induction, single or double ASCT, consolidation, and maintenance therapy. More recently, incorporating second-generation proteasome inhibitors carfi

Понимание и решение проблемы сопротивления иммуномодуляционным соединениям IMID в множестве миеломы.

Лекарственные средства иммуномодулирования (ИМИД), включая линалидомид и помалидомид в сочетании с протеаозными ингибиторами, дексаметазоном и антиCD38 моноклональными антителами, играют центральную роль в лечении множественной миеломы (ММ) на новых диагностированных и рецидивированных этапах. Эти методы лечения значительно улучшили результаты лечения пациентов во всем мире, в результате чего IMID стали одной из опор MM-терапии. В настоящее время разрабатывается новое поколение более мощных соединений, называемых лигами-модуляторами цереблиона Е3 (CELMODs), которые могут заменить старые IMID.

Agents contributing to secondary immunodeficiency development in patients with multiple myeloma, chronic lymphocytic leukemia and non-Hodgkin lymphoma: A systematic literature review.

IntroductionPatients with hematological malignancies (HMs), like chronic lymphocytic leukemia (CLL), multiple myeloma (MM), and non-Hodgkin lymphoma (NHL), have a high risk of secondary immunodeficiency (SID), SID-related infections, and mortality. Here, we report the results of a systematic literature review on the potential association of various cancer regimens with infection rates, neutropenia, lymphocytopenia, or hypogammaglobulinemia, indicative of SID.MethodsA systematic literature search was performed in 03/2022 using PubMed to search for clinical trials that mentioned in the title and

Более низкая доза и еженедельные графики селинксора в множестве миеломы - обновленные данные о безопасности и эффективности.

Фон Селинксор, первый в классе, оральный exportin-1 Ингибитор продемонстрировал активность в пента-рефракторной миеломе (ММ) в ходе ранней экспериментальной разведки; однако побочный эффект двухнедельного дозирования привел к тому, что он нерешителен и стал частью широко распространенной практики. В данном случае наша цель состоит в том, чтобы предоставить обновленные клинические данные, свидетельствующие о сохранении эффективности и более высокой терпимости селинексора раз в неделю при более низких дозах у пациентов с ранее обработанными MM по сравнению с данными о двухнедельном режиме. XPORT