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Clinical Outcomes of Patients with Multiple Myeloma Presenting with Renal Failure.

Aims and objectiveThis article studies the clinical outcome of patients with multiple myeloma who have renal failure at presentation.MethodologyPatients with multiple myeloma presenting with serum creatinine of more than or equal to 2 mg/dL from outpatient department at Sri Ram Cancer Centre, Mahatma Gandhi Medical College & Hospital, Jaipur, Rajasthan, India, were screened for baseline serum creatinine and estimated glomerular filtration rate (eGFR). Assessment was done at completion of 6 months from diagnosis-patients' clinical condition, renal response (serum creatinine and eGFR), and disea

Иксазомиб, помалидомид и дексаметасон в реанимированных или рефрактных миеломах, характеризующихся высокой степенью риска цитогенетики: 2014-01 Учёба.

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Current and New Therapeutic Strategies for Relapsed and Refractory Multiple Myeloma: An Update.

Although survival of multiple myeloma patients has at least doubled during recent years, most patients eventually relapse, and treatment at this stage may be particularly complex. At the time of relapse, the use of alternative drugs to those given upfront is current practice. However, many new options are currently available for the treatment of relapsed multiple myeloma, including recently approved drugs, such as the second- and third-generation proteasome inhibitors carfilzomib and ixazomib, the immunomodulatory agent pomalidomide, the monoclonal antibodies daratumumab and elotuzumab and the

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… Fit patients can be eligible for full-dose triplet-therapies, whereas unfit and frail patients may benefit from less-intensive triplet-regimens, doublet regimens or dose reductions according to expert-based local guidelines. … Although triplet therapies do not completely abrogate poor prognosis associated with high-risk cytogenetics, compared to doublet therapies, triplets improve PFS both in standard-risk and in high-risk patients [ 57 , 61 , 72 , 125 ]. …

Discontinuation of maintenance therapy in multiple myeloma guided by multimodal measurable residual disease negativity (MRD2STOP).

MRD2STOP is a pragmatic trial evaluating maintenance therapy cessation guided by measurable residual disease (MRD) negativity in multiple myeloma (MM). Eligible patients had previous MRD -5, received ≥1 year of maintenance, and were prospectively confirmed to have undetectable disease by positron emission tomography, bone marrow (BM) flow cytometry (limit of detection [LoD] 10-5), and BM clonoSEQ (LoD 10-6). BM aspirates enriched for CD138+ cells were analyzed by clonoSEQ to achieve MRD 10-7 sensitivity. We evaluated the incidence of disease resurgence and progression-free survival (PFS), stra

Carfilzomib prescribing patterns and outcomes for relapsed or refractory multiple myeloma: a real-world analysis.

Despite the widespread use of carfilzomib (K) in relapsed/refractory multiple myeloma (RRMM), there is no consensus on optimal K dose in milligrams per square meter (mg/m2) or dosing schedule. We assessed three modern K prescribing patterns in RRMM using a large United States electronic health record-derived database. Our final cohort (n = 486) included 136 patients (28.0%) who received K 56 mg/m2 once weekly (K56-1x), 86 (17.7%) who received 56 mg/m2 twice weekly (K56-2x), and 264 (54.3%) who received 70 mg/m2 once weekly (K70-1x). Between 2016 and 2023, once-weekly dosing became more common:

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… Overall, most patients (57.0%, n = 277) received carfilzomib as part of a triplet regimen. For example, CD38 mAbs with Kd were used in 30.7% of patients ( n = 149) while IMiDs with Kd were used in 18.1% of patients ( n = 88). … However, K-containing triplets or quadruplets were not included in that study, and only 9% of analyzed patients had received a modern carfilzomib dosing schedule. …

Multiple myeloma care, treatment patterns, and treatment durations in academic and community care settings.

AIM: Evaluate multiple myeloma (MM) treatment patterns, healthcare utilization (HCRU), and costs from academic and community settings. METHODS: This observational study linked US MM insurance claims (1 April 2017-30 June 2022) with provider affiliations to evaluate patient characteristics and treatment durations across patient cohorts defined by care setting of treatment (academic only, community only, mixed [both]), as well as treatment patterns, HCRU, and costs of care (e.g. treatment, office visits, hospitalization) in each setting. RESULTS: 3778 patients were included. By cohort (n = 530

The risk of birth defects with conception by ART.

STUDY QUESTION: What is the association between ART conception and treatment parameters and the risk of birth defects? SUMMARY ANSWER: Comp … limited to fresh embryos were stratified by oocyte source (autologous, donor) and the use of ICSI. Triplets and higher-order multiples were excluded. MAIN RESULTS AND THE ROLE OF CHANCE: A total of 21 998 singleton children (1.9%) and 3037 twin children (3.3%) had a major birth defect. Compared to naturally conceived children, ART singletons (conceived f …

Воздействие остаточных клональных плазменных клеток в фазе S во время аутологической трансплантации стволовых клеток на клинические результаты.

Автологическая трансплантация стволовых клеток (ASCT) является ключевой терапевтической стратегией для многих пациентов, у которых диагностируется миелома (ММ), однако ранние рецидивы после трансплантации остаются серьезной клинической проблемой. Испытание на распространение плазменных клеток (ПХПРО), в ходе которого определяется доля клональных плазменных клеток в костном мозге в фазе S-фазе (S-фаза %), представляет собой масштабируемую альтернативу измерению их скорости распространения по сравнению со старым индексом плазменных клеток (PCLI). Воздействие S-фазы в остаточных клональных плазме

Outcomes of newly diagnosed myeloma patients requiring dialysis: renal recovery, importance of rapid response and survival benefit.

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The clinical journey of belantamab mafodotin in relapsed or refractory multiple myeloma: lessons in drug development.

Patients with relapsed/refractory multiple myeloma (RRMM) have a poor prognosis and a need remains for novel effective therapies. Belantamab mafodotin, an anti-B-cell maturation antigen antibody-drug conjugate, was granted accelerated/conditional approval for patients with RRMM who have received at least 4 prior lines of therapy, based on response rates observed in DREAMM-1/DREAMM-2. Despite the 41% response rate and durable responses observed with belantamab mafodotin in the Phase III confirmatory DREAMM-3 trial, the marketing license for belantamab mafodotin was later withdrawn from US and E

Mezigdomide-A Novel Cereblon E3 Ligase Moduler под следствием в Replapsed/ Refractory Multieloma.

Mezigomide — пероральный модулятор лигаса Е3 (CELMOD), который находится под клиническим исследованием у пациентов с множественным миэломой (MM) responsed/refractory (RR). Как и другие соединения CELMOD, мезигдомид действует, изменяя конформацию церебрально-церебрального узла Cullin 4A кольца Ligase-Cereblon (CRL4CRBN) E3 Ubisquitin Ligase, тем самым привлекая новые белковые субстраты для селективной протеасомальной деградации. К ним относятся: two Критические лимфоидные коэффициенты транскрипции, протеины цинкового пальца семейства Икарос 1 и 3 (IKZF1 и IKZF3), также известные как Ikaros и Ai

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… These findings provide the rationale for the investigation of mezigdomide–PI–dexamethasone triplet regimens in the clinic. … triplets [ 94 , 95 , 96 ]. …

Current Main Topics in Multiple Myeloma.

Multiple Myeloma (MM) remains a difficult to treat disease mainly due to its biological heterogeneity, of which we are more and more knowledgeable thanks to the development of increasingly sensitive molecular methods that allow us to build better prognostication models. The biological diversity translates into a wide range of clinical outcomes from long-lasting remission in some patients to very early relapse in others. In NDMM transplant eligible (TE) patients, the incorporation of mAb as daratumumab in the induction regimens, followed by autologous stem cell transplantation (ASCT) and consol

Monoclonal Antibodies: Leading Actors in the Relapsed/Refractory Multiple Myeloma Treatment.

Multiple myeloma is a complex hematologic malignancy, and despite a survival improvement related to the growing number of available therapeutic options since 2000s, it remains an incurable disease with most patients experiencing relapse. However, therapeutic options for this disease are constantly evolving and immunotherapy is becoming the mainstay of the therapeutic armamentarium of Multiple Myeloma (MM), starting with monoclonal antibodies (MoAbs) as elotuzumab, daratumumab and isatuximab. Elotuzumab, the first in class targeting SLAMF7, in combination with lenalidomide and dexamethasone and

Selinexor: Targeting a novel pathway in multiple myeloma.

Selinexor is an orally bioavailable selective inhibitor of nuclear export compound that inhibits exportin-1 (XPO1), a novel therapeutic target that is overexpressed in multiple myeloma (MM) and is responsible for the transport of ∼220 nuclear proteins to the cytoplasm, including tumour suppressor proteins. Inhibition of this process has demonstrated substantial antimyeloma activity in preclinical studies, both alone and in combination with established MM therapeutics. Based on a clinical trial programme encompassing multiple combination regimens, selinexor-based therapy has been approved for t

US Budget Impact Model for Selinexor, Bortezomib, and Dexamethasone for the Treatment of Previously Treated Multiple Myeloma.

PURPOSE: To estimate the budget impact of selinexor, bortezomib, and dexamethasone (XVd) in patients with previously treated multiple myeloma (MM) from the perspective of a private third-party payer and Medicare in the US. METHODS: The introduction of XVd as an option for patients with previously treated MM compared to no introduction of XVd was considered from a private third-party US payer (with 1,000,000 members) and a Medicare perspective in one-year increments for 3 years. Total annual treatment costs were calculated as the sum of drug costs, costs of treating serious treatment emergent

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… This once weekly triplet XVd therapy was superior to standard twice weekly Vd despite using 40% less bortezomib and 25% less dexamethasone during the first 24 weeks of treatment than the control arm. … Compared to Vd (and previous Vd-based triplets), XVd offers several benefits to vulnerable patients: less overall bortezomib use, reduced dexamethasone, reduced neuropathy rates, and fewer clinic visits and their associated risks. …

Real-World Data on the Efficacy of Daratumumab in Patients with Relapsed/Refractory Multiple Myeloma and Amplification 1q.

Background: Treatment of multiple myeloma has advanced tremendously with the approval of anti-CD38 antibodies. Their efficacy is impressive but still controversial in the 1q amplification subgroup (amp1q). This retrospective study aims to provide real-world data. Methods: This trial is analyzing 74 patients with relapsed/refractory multiple myeloma treated with CD38Abs at the Medical University of Innsbruck (2016-2023). High-risk (HR) cytogenetics according to R-ISS (t(4;14), t(14;16), t(14;20), del(17p)), the presence of amp(1q21), the frequency of two HR markers (double hit), and the high-ri

Prioritising systemic cancer therapies applying ESMO's tools and other resources to assist in improving cancer care globally: the Kazakh experience.

BackgroundIn Kazakhstan, cancer is the second leading cause of death with a major public health and economic burden. In the last decade, cancer care and cancer medicine costs have significantly increased. To improve the efficiency and efficacy of cancer care expenditure and planning, the Kazakhstan Ministry of Health requested assistance from the World Health Organization (WHO) and the European Society for Medical Oncology (ESMO) to review its systemic cancer treatment protocols and essential medicines list and identify high-impact, effective regimens.Materials and methodsESMO developed a four

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… Doublet or triplet platinum/fluoropyrimidine combinations are recommended for fit patients with advanced gastric cancer [I, A]. Triplets containing taxanes are also an evidence-based treatment choice for first-line chemotherapy. 2. … Doublet or triplet platinum/fluoropyrimidine combinations are recommended for fit patients with advanced gastric cancer [I, A]. Triplets containing taxanes are also an evidence-based treatment choice for first-line chemotherapy. 2. …

Novel Experimental Drugs for Treatment of Multiple Myeloma.

Multiple myeloma (MM) is the second most frequent hematological malignancy characterized by bone marrow aberrant plasma cells proliferation leading to a genetic complex and heterogeneous disease, with a median survival ranging from two to more than 10 years. By using new drugs such as proteasome inhibitors (PIs), immunomodulatory drugs (IMiDs), monoclonal antibodies (mAbs) in different combinations and high-dose therapy followed by auto-transplantation, there has been an amazing improvement in the outcome of this disease in recent years. Despite this, MM is still considered an incurable diseas

In search of the optimal proteosome inhibitor. How, when and for whom?

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… Moreover, the PFS in the carfilzomib maintenance and observation arms was 11.9 versus 5.6 months, respectively. 1 Side-by-side comparisons of bortezomib and carfilzomib doublets (ENDEAVOR) 2 and triplets (CLARION, ENDURANCE) 3 , 4 have been reported. … Table 1 summarizes the information regarding selected carfilzomib- and bortezomib-containing doublets, triplets and quadruplets in RRMM/NDMM, and in transplant-eligible and –ineligible patients. …

Лучшие достижения года: Биотипные антитела на ранних линиях терапии в множестве миеломы.

После их введения в качестве терапии для сильного рефрактного множества миэломы, лица, занимающиеся диагностикой двух клеток, недавно получили исключительно глубокие и долговременные ответные реакции на ранние линии терапии, включая ранние данные о новых диагностированных болезнях. Сохраняется множество проблем, включая оптимальную обстановку и сочетание, смягчение токсичности и уточнение оптимальной продолжительности терапии.