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Hematology (Amsterdam, Netherlands) Dec 2022Multiple myeloma in Latin America (LATAM) face multiple challenges related to the lack of resources according to low- and middle-income in the region. (Review)
Review
INTRODUCTION
Multiple myeloma in Latin America (LATAM) face multiple challenges related to the lack of resources according to low- and middle-income in the region.
AREAS COVERED
in this narrative review, several aspects of myeloma multiple epidemiology, diagnostic methods and risk stratification, medication commonly employed, and treatment results in LATAM are discussed.
CONCLUSION
Patients usually are diagnosed in an advanced stage of the disease, and routine and risk evaluations are usually not ideal due to lack of access to different studies. Treatment is limited in many cases to the use of thalidomide and dexamethasone with and without cyclophosphamide. Access to autologous stem cell transplantation is far from ideal. Efforts must be made at the national health system level in our countries to offer our vast majority of MM patients a real chance to improve results in the diagnostic, risk stratification, and treatment. Currently, several groups in our region are working to make an impact in the field of MM.
Topics: Antineoplastic Combined Chemotherapy Protocols; Dexamethasone; Hematopoietic Stem Cell Transplantation; Humans; Latin America; Multiple Myeloma; Thalidomide; Transplantation, Autologous
PubMed: 36000971
DOI: 10.1080/16078454.2022.2112643 -
Der Internist May 2021Multiple myeloma (MM) is one of the most frequent cancerous diseases of the hemopoietic system. Over the past 60 years the systemic treatment has undergone multiple... (Review)
Review
Multiple myeloma (MM) is one of the most frequent cancerous diseases of the hemopoietic system. Over the past 60 years the systemic treatment has undergone multiple changes, from alkylating agents to high-dose therapy followed by autologous peripheral blood stem cell transplantation up to immunomodulating substances and proteasome inhibitors. The treatment of MM is currently undergoing a renewed transition. In recent years monoclonal antibodies have decisively extended the treatment options. Long-term remission is achieved more often. Due to progress in immuno-oncological treatment the prognosis of intensively treated patients with a very short life-expectancy can be improved in the future. It is to be expected that MM will be curable in the medium term. The concentration of free light chains in serum, lesions in magnetic resonance imaging (MRI) and bone marrow infiltration are parameters that are incorporated into the treatment indications. In clinical studies patients with smoldering myeloma are already being treated to delay progression, to increase the remission rates or to achieve long-term remission with negative minimal residual disease. Taking the chromosomal alterations and serological parameters into consideration, the prognosis of patients with MM can nowadays be very well discriminated. In currently running studies high-risk patients are being separately and mostly aggressively treated. Imaging is of great importance in MM. Using MRI focal lesions can be detected even before bone destruction. In this year chimeric antigen receptor (CAR) T cell treatment of MM will be approved for the first time in Germany. Novel antibody constructs, such as belantamab mafodotin, are or will be introduced for a late recurrence.
Topics: Antibodies, Monoclonal; Germany; Humans; Multiple Myeloma; Proteasome Inhibitors; T-Lymphocytes
PubMed: 33783581
DOI: 10.1007/s00108-021-01010-3 -
Discovery Medicine Oct 2023Synchronous or sequential development of multiple myeloma and prostate carcinoma is rare. It is not sure whether these two occur independently or if one influences the... (Review)
Review
Synchronous or sequential development of multiple myeloma and prostate carcinoma is rare. It is not sure whether these two occur independently or if one influences the development of the other. We reviewed the cases published in the English literature; eight cases of myeloma developing after diagnosis and treatment for prostate carcinoma, five cases of simultaneous occurrence of myeloma and prostate carcinoma, and five cases where the patient with multiple myeloma later developed prostate carcinoma were found. This short review attempts to analyze the occurrence of these two diseases in the same patient and dissect whether there is a close association or it is just a mere coincidence.
Topics: Male; Humans; Multiple Myeloma; Prostate; Prostatic Neoplasms; Carcinoma
PubMed: 37811608
DOI: 10.24976/Discov.Med.202335178.65 -
Nature Nov 2020
Topics: Black People; Early Detection of Cancer; Healthcare Disparities; Humans; Immunotherapy; Monoclonal Gammopathy of Undetermined Significance; Multiple Myeloma; Oncolytic Virotherapy; Prognosis; White People
PubMed: 33239804
DOI: 10.1038/d41586-020-03223-2 -
Expert Review of Anticancer Therapy May 2024The prognosis of multiple myeloma (MM) continues to improve. Recent progress in therapies, using immunomodulatory drugs (IMiDs), proteasome inhibitors (PIs), and... (Review)
Review
INTRODUCTION
The prognosis of multiple myeloma (MM) continues to improve. Recent progress in therapies, using immunomodulatory drugs (IMiDs), proteasome inhibitors (PIs), and anti-CD38 monoclonal antibodies, has greatly improved patients' outcomes. Despite these advancements, relapses still happen often, and patients can become resistant to the usual treatments. Newer treatments, such as chimeric antigen receptor (CAR) T-cell therapy and bispecific antibodies (BsAbs) targeting B-cell maturation antigen (BCMA), have resulted in excellent outcomes in patients with limited treatment options. G protein - coupled receptor, class C group 5 member D (GPRC5D) is considered a very promising target with early results from clinical trials showing high response rates in patients with relapsed or refractory multiple myeloma.
AREAS COVERED
This review covers the efficacy and safety of CAR-T and BsAbs targeting GPRC5D in MM, focusing on talquetamab - the inaugural FDA-approved BsAb targeting GPRC5D. Talquetamab has exhibited promising response rates alongside a distinctive side effect profile. Additionally, ongoing trials examining talquetamab in combination with agents like daratumumab and teclistamab are discussed.
EXPERT OPINION
We offer insights into the potential utilization of various GPRC5D-based therapies in the treatment paradigm for MM, either independently or in combination with established therapies.
Topics: Humans; Multiple Myeloma; Receptors, G-Protein-Coupled; Immunotherapy, Adoptive; Molecular Targeted Therapy; Antibodies, Bispecific; Animals; Prognosis
PubMed: 38607646
DOI: 10.1080/14737140.2024.2343114 -
Hematology/oncology Clinics of North... Apr 2024Improving the outcome of high-risk myeloma (HRMM) is a key therapeutic aim for the next decade. To achieve this aim, it is necessary to understand in detail the genetic... (Review)
Review
Improving the outcome of high-risk myeloma (HRMM) is a key therapeutic aim for the next decade. To achieve this aim, it is necessary to understand in detail the genetic drivers underlying this clinical behavior and to target its biology therapeutically. Advances have already been made, with a focus on consensus guidance and the application of novel immunotherapeutic approaches. Cases of HRMM are likely to have impaired prognosis even with novel strategies. However, if disease eradication and minimal disease states are achieved, then cure may be possible.
Topics: Humans; Multiple Myeloma; Prognosis
PubMed: 38195306
DOI: 10.1016/j.hoc.2023.12.008 -
Panminerva Medica Dec 2020
Topics: Antineoplastic Agents; Congresses as Topic; Humans; Immunotherapy, Adoptive; Multiple Myeloma; Stem Cell Transplantation; Treatment Outcome
PubMed: 32957745
DOI: 10.23736/S0031-0808.20.04159-2 -
Clinical Cancer Research : An Official... Aug 2021Among the hallmarks of cancer is the ability of neoplastic cells to evade and suppress immune surveillance to allow their growth and evolution. Nowhere is this as... (Review)
Review
Among the hallmarks of cancer is the ability of neoplastic cells to evade and suppress immune surveillance to allow their growth and evolution. Nowhere is this as apparent as in multiple myeloma, a cancer of antibody-producing plasma cells, where a complex interplay between neoplastic cells and the immune microenvironment is required for the development and progression of disease. Decades of research has led to the discovery of a number of therapeutic agents, from cytotoxic drugs to genetically engineered cells that mediate their antimyeloma effects at least partially through altering these immune interactions. In this review, we discuss the history of immunotherapy and current practices in multiple myeloma, as well as the advances that promise to one day offer a cure for this deadly disease.
Topics: Humans; Immunotherapy; Multiple Myeloma
PubMed: 33771856
DOI: 10.1158/1078-0432.CCR-20-3600 -
Trends in Cancer Oct 2020Genomic instability (GIN), an increased tendency to acquire genomic alterations, is a cancer hallmark. However, its frequency, underlying causes, and disease relevance... (Review)
Review
Genomic instability (GIN), an increased tendency to acquire genomic alterations, is a cancer hallmark. However, its frequency, underlying causes, and disease relevance vary across different cancers. Multiple myeloma (MM), a plasma cell malignancy, evolves through premalignant phases characterized by genomic abnormalities. Next-generation sequencing (NGS) methods are deconstructing the genomic landscape of MM across the continuum of its development, inextricably linking malignant transformation and disease progression with increasing acquisition of genomic alterations, and illuminating the mechanisms that generate these alterations. Although GIN drives disease evolution, it also creates vulnerabilities such as dependencies on 'superfluous' repair mechanisms and the induction of tumor-specific antigens that can be targeted. We review the mechanisms of GIN in MM, the associated vulnerabilities, and therapeutic targeting strategies.
Topics: Animals; Genomic Instability; Humans; Multiple Myeloma
PubMed: 32487486
DOI: 10.1016/j.trecan.2020.05.006 -
Blood Reviews Mar 2024Multiple myeloma is a plasma cell neoplasm driven by primary (e.g. hyperdiploidy; IGH translocations) and secondary (e.g. 1q21 gains/amplifications; del(17p); MYC... (Review)
Review
Multiple myeloma is a plasma cell neoplasm driven by primary (e.g. hyperdiploidy; IGH translocations) and secondary (e.g. 1q21 gains/amplifications; del(17p); MYC translocations) chromosomal events. These are important to detect as they influence prognosis, therapeutic response and disease survival. Currently, cytogenetic testing is most commonly performed by interphase fluorescence in situ hybridisation (FISH) on aspirated bone marrow samples. A number of variations to FISH methodology are available, including prior plasma cell enrichment and incorporation of immunophenotypic plasma cell identification. Other molecular methods are increasingly being utilised to provide a genome-wide view at high resolution (e.g. single nucleotide polymorphism (SNP) microarray analysis) and these can detect abnormalities in most cases. Despite their wide application at diagnostic assessment, both FISH and SNP-array have relatively low sensitivity, limiting their use for identification of prognostically significant low-level sub-clones or for disease monitoring. Next-generation sequencing is increasingly being used to detect mutations and new FISH techniques such as by flow cytometry are in development and may address some of the current test limitations. Here we review the primary and secondary cytogenetic aberrations in myeloma and discuss the range of techniques available for their assessment.
Topics: Humans; Multiple Myeloma; Chromosome Aberrations; Translocation, Genetic; In Situ Hybridization, Fluorescence; Gene Rearrangement
PubMed: 38212176
DOI: 10.1016/j.blre.2024.101168