Rebooting the Myeloma Treatment Programme

Abstract

Multiple myeloma (MM), characterised by the clonal proliferation of malignant plasma cells, results in the overproduction of monoclonal immunoglobulins.1 Genetic heterogeneity of these clones confers treatment resistance and contributes to disease progression. Therefore, the use of combination therapies with different mechanisms of action can target the maximum number of clones simultaneously and may achieve long-term disease control.2 Current therapeutic strategies, such as chemotherapy, radiotherapy, proteasome inhibitors (PI), immunomodulatory drugs (IMiD), monoclonal antibodies, and autologous/allogeneic stem cell transplantation have resulted in improved outcomes for MM patients. However, these therapies rarely induce long-lasting complete remissions, and patients frequently develop resistance to treatments. As such, the search for novel treatment strategies, including personalised immunotherapies, is ongoing to overcome resistance and improve patient survival.