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Targets for CAR Therapy in Multiple Myeloma.

Multiple myeloma (MM or plasma cell myeloma) is a heterogenous B-cell malignant tumor that typically exhibits a high recurrence rate, resistance to drugs, and molecular diversity of tumor subclones. Given the limited efficacy of standard therapy options, cellular immunotherapy featuring a chimeric antigen receptor (CAR) has proven tangible potential in treatment for relapsed and refractory forms of MM. The rational choice of a tumor target which shows high selectivity, stable expression, and biological significance is key to the successful implementation of CAR therapy. This review has summari…

Belantamab mafodotin for the treatment of multiple myeloma.

INTRODUCTION: Advances in frontline multiple myeloma (MM) treatment, through combinatorial regimens with diverse mechanisms of action, have created a need for alternative agents at relapse. BCMA-targeting CAR-T therapies have already demonstrated superiority over conventional options. Belantamab mafodotin, a first-in-class BCMA-directed antibody - drug conjugate (ADC), has shown significant benefit in combination with proteasome inhibitors or immunomodulators, as an accessible alternative to CAR-T therapy. AREAS COVERED: Belantamab mafodotin-based regimens were approved for the treatment of M…

[The Applications of Hematoporphyrin in the Treatment of Multiple Myeloma].

OBJECTIVE: Photodynamic therapy has become an important method in clinical tumor treatment. This study aimed to investigate the effects of hematoporphyrin on multiple myeloma (MM) and its potential applications. METHODS: The MM cell line RPMI 8226 was treated with hematoporphyrin derivative (HPD), and CCK-8 assay was used to determine cell viability, apoptosis was detected by flow cytometry, intracellular reactive oxygen species (ROS) levels were measured using a detection kit combined with flow cytometry, and Western blot assay was used to detect apoptosis-related proteins and key signaling …

Роль агентов CELMOD в Мультимиломе.

Несмотря на то, что в последние десятилетия наблюдалось дальнейшее улучшение положения в области выживания пациентов с множественными миеломами, это заболевание в значительной степени остается неизлечимым, и большинство пациентов переживают рецидивы и/или становятся невосприимчивыми к лечению. Таким образом, по-прежнему остро ощущается потребность в новых методах лечения, особенно для тех пациентов с рецидивистской или рефрактной множественной миеломой. Новейшие методы лечения, такие, как целевая деградация белка, вызывают особый интерес, поскольку они позволяют расширить диапазон поддающихся …

MRD в нескольких миеломах: клиническая перспектива.

Минимальное остаточное заболевание (МРД) стало ключевым прогнозным фактором в случае множественной миэломы (ММ), что позволяет более точно оценивать эффективность лечения после обычной полной ремиссии. Технологии высокой чувствительности, включая цитометрию потока следующего поколения (СПГ), последовательность следующего поколения (СПГ) и количественную PCR для олигонуклеотида аллеля, позволяют обнаруживать остаточные заболевания при уровнях 10-5-10-6. Достижение негатива MRD последовательно ассоциируется с продолжительным безподвижным выживанием (PFS) и общим выживанием (OS) в различных услов

Совпадение в аннотации оригинала
Minimal residual disease (MRD) has emerged as a key prognostic factor in multiple myeloma (MM), allowing a more accurate evaluation of treatment efficacy beyond conventional complete remission. High-sensitivity techniques, including next-generation flow cytometry (NGF), next-generation sequencing (NGS), and allele-specific oligonucleotide quantitative PCR, e…

Вакцинация в множественных миеломах: проблемы и стратегии.

Множественная миелома (ММ) — гематологическая халатность, характеризующаяся глубоким иммунодепрессией, вызванной как механизмами, связанными с заболеваниями, так и иммунной дисфункцией, вызванной лечением. Это скомпрометировало иммунный статус, что значительно повышает подверженность инфекциям, что является одной из основных причин заболеваемости и смертности у пациентов с ОМ. Хотя вакцинация является краеугольным камнем профилактики инфекции, стандартные стратегии иммунизации часто дают неоптимальную реакцию для этой группы населения. ЦЕЛИ: В настоящем обзоре обобщены имеющиеся данные об имму…

Impact of Clonal Heterogeneity in Multiple Myeloma.

Multiple myeloma is characterized by a highly heterogeneous disease distribution within the bone marrow-containing skeletal system. In this review, we introduce the molecular mechanisms underlying clonal heterogeneity and the spatio-temporal evolution of myeloma. We discuss the clinical impact of clonal heterogeneity, which is thought to be one of the biggest obstacles to overcome therapy resistance and to achieve cure.

Imaging of Multiple Myeloma: Present and Future.

Multiple myeloma (MM) is the second most common adult hematologic malignancy, and early intervention increases survival in asymptomatic high-risk patients. Imaging is crucial for the diagnosis and follow-up of MM, as the detection of bone and bone marrow lesions often dictates the decision to start treatment. Low-dose whole-body computed tomography (CT) is the modality of choice for the initial assessment, and dual-energy CT is a developing technique with the potential for detecting non-lytic marrow infiltration and evaluating the response to treatment. Magnetic resonance imaging (MRI) is more…

Adipocytes and metabolism: Contributions to multiple myeloma.

Obesity contributes to many cancers, including breast cancer and multiple myeloma, two cancers that often colonize the bone marrow (BM). Obesity often causes metabolic disease, but at the cellular level, there is uncertainty regarding how these shifts affect cellular phenotypes. Evidence is building that different types of fuel affect tumor cell metabolism, mitochondrial function, and signaling pathways differently, but tumor cells are also flexible and adapt to less-than ideal metabolic conditions, suggesting that single-pronged attacks on tumor metabolism may not be efficacious enough to be …

A Role for Germline Variants in Multiple Myeloma?

In Blood Cancer Discovery, Thibaud and colleagues report the incidence of pathogenic germline variants (PGV) in patients with multiple myeloma and that these PGVs are associated with DNA repair pathway genes, including BRCA1 and BRCA2. They find an association of patients with PGVs and previous family or personal history of cancer, and that these patients are diagnosed slightly earlier than those without PGVs. Patients with PGVs had a longer progression-free survival than those without PGVs when they received high-dose melphalan and autologous stem cell transplant, providing a therapeutic rati…

Treatment of multiple myeloma with selinexor: a review.

Over the last 20 years, breakthroughs in accessible therapies for the treatment of multiple myeloma (MM) have been made. Nevertheless, patients with MM resistant to immunomodulatory drugs, proteasome inhibitors, and anti-CD38 monoclonal antibodies have a very poor outcome. Therefore, it is necessary to explore new drugs for the treatment of MM. This review summarizes the mechanism of action of selinexor, relevant primary clinical trials, and recent developments in both patients with relapsed/refractory myeloma and patients with newly diagnosed myeloma. Selinexor may be useful for the treatment…

Bispecific antibodies in the treatment of multiple myeloma.

The treatment paradigm in myeloma is constantly changing. Upfront use of monoclonal antibodies like daratumumab along with proteasome inhibitors (PI)s, and immune modulators (IMiD)s have significantly improved survival and outcomes, but also cause unique challenges at the time of relapse. Engaging immune T cells for tumour cell kill with chimeric antigenic T-cell (CAR T-cell) therapy and bispecific antibodies have become important therapeutic options in relapsed multiple myeloma. Bispecific antibodies are dual antigen targeting constructs that engage the T cells to plasma cells through various…

The Dynamics of Financial Toxicity in Multiple Myeloma.

INTRODUCTION/BACKGROUND: People with multiple myeloma are at risk for financial toxicity due to the high cost of treatment and prolonged treatment duration. However, little data exist regarding financial toxicity among people with myeloma. PATIENTS AND METHODS: In this study, a cohort of 135 patients were recruited from an ongoing observational trial to complete the Comprehensive Score for financial Toxicity (COST). Participants were sent follow-up surveys at 3, 6, and 12 months. RESULTS: The median age was 68 years; the majority were non-Hispanic whites (88%), male (63%), held a college deg…

Monoclonal Antibodies in the Treatment of Multiple Myeloma.

The incorporation of monoclonal antibodies into backbone regimens has substantially improved the clinical outcomes of patients with newly diagnosed and relapsed/refractory multiple myeloma (MM). Although the SLAMF7-targeting antibody elotuzumab has no single- agent activity, there is clinical synergy between elotuzumab and immunomodulatory drugs in patients with relapsed/refractory disease. Daratumumab and isatuximab are CD38-targeting antibodies which have single-agent activity and a favorable safety profile, which make these agents an attractive component of combination regimens. Monoclonal …

A Case of Concomitant Multiple Myeloma and Cirrhosis.

A 66-year-old Caucasian female with a recent history of COVID-19 (about one month prior to the current admission) and cirrhosis, presented w … isorder. A bone survey did not indicate aggressive bone lesions, but a bone marrow biopsy confirmed multiple myeloma with approximately 10% kappa light chain-restricted plasma cells. Despite appropriate treatment, the patient's health continued to decline, and the patient was subsequently transitioned to comfort care. While the relationship between cirrhosis and m …

Management of Renal Failure in Multiple Myeloma

Multiple myeloma (MM) is a monoclonal plasma cell neoplasia that commonly involves the kidney. Renal impairment is a serious complication during the course of the disease, and it is associated with increased morbidity and mortality. The most frequent mechanism of injury is represented by the precipitation of monoclonal free light chains (FLCs) in the distal tubule of nephron, defining a dramatic condition known as light chain cast nephropathy (LCCN). A prompt and early identification of the cause of renal disease, particularly in case of acute kidney injury (AKI), is mandatory for its effectiv…

A case of Multiple Myeloma with lung plasmacytoma.

Multiple Myeloma (MM) is a malignant proliferation of the plasma cells mainly affecting bone marrow. Most common sites of extramedullary dissemination reported in the literature are skin, liver, kidneys and central nervous system. Multiple Myeloma is rarely associated with lung plasmacytoma. In fact; dissemination of MM in lung is relatively uncommon being described in only 5% of cases and therefore the diagnosis of this entity can be misleading to most clinicians. We report a rare case of lung plasmacytoma with MM in a 65-year-old, smoker, male who presented with shortness of breath and a het…