: 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 newer agents and maintenance treatment following a more intense induction phase proved to be superior as compared to fixed-duration therapy. Maintenance and continuous therapy at diagnosis have shown to deepen responses and suppress minimal residual disease. At relapse, continuous therapy allowed better disease control over time. This review covers the main evidence supporting the use of continuous therapy in multiple myeloma as well as the open issues, such as the optimal agents to be used and the optimal candidates for receiving them.

Moving Toward Continuous Therapy in Multiple Myeloma

Bonello, Francesca
First
;
Cetani, Giusy;Bertamini, Luca;Gay, Francesca;Larocca, Alessandra
Last
2019

Abstract

: 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 newer agents and maintenance treatment following a more intense induction phase proved to be superior as compared to fixed-duration therapy. Maintenance and continuous therapy at diagnosis have shown to deepen responses and suppress minimal residual disease. At relapse, continuous therapy allowed better disease control over time. This review covers the main evidence supporting the use of continuous therapy in multiple myeloma as well as the open issues, such as the optimal agents to be used and the optimal candidates for receiving them.
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189
200
https://www.atlantis-press.com/journals/chi/125921749
https://doi.org/10.2991/chi.d.191101.001
Continuous therapy; Immunomodulatory agents; Maintenance; Monoclonal antibodies; Multiple myeloma; Proteasome inhibitors
Bonello, Francesca; Cetani, Giusy; Bertamini, Luca; Gay, Francesca; Larocca, Alessandra
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Descrizione: [PUBLISHED Vsn.] Bonello et al. Clin Hematol Int . 2019 Nov 12;1(4):189-200. doi: 10.2991/chi.d.191101.001. CC BY-NC 4.0 - © 2019 International Academy for Clinical Hematology. Publishing services by Atlantis Press International B.V. Available at / disponibile all’URL: https://www.atlantis-press.com/journals/chi/125921749 | https://doi.org/10.2991/chi.d.191101.001
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2318/1850581
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