Insights from Clinical Trials: Evidence-Based Recommendations for Induction Treatment of Newly Diagnosed Transplant-Eligible Multiple Myeloma.

IF 3 Q3 IMMUNOLOGY

Antibodies Pub Date : 2024-09-29 DOI:10.3390/antib13040080

Olga Lytvynova, Jenna Jwayyed, Daniel Pastel, Rohan Prasad, Jack Khouri, Louis Williams, Sandra Mazzoni, Shahzad Raza, Faiz Anwer

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Abstract

Multiple myeloma (MM) is a hematological malignancy and poses significant therapeutic challenges. This review synthesizes evidence from pivotal clinical trials to guide induction treatment for transplant-eligible (TE), newly diagnosed MM (NDMM) patients. Emphasizing the evolution from three-drug to four-drug induction therapies, we highlight the integration of monoclonal antibodies, particularly CD38 recombinant monoclonal antibody agents, into treatment regimens. This analysis includes a comprehensive literature review of research from major databases and conferences conducted between 2010 and 2023, culminating in the detailed evaluation of 47 studies. The findings underscore the superiority of quadruple regimens in TE NDMM, notably those incorporating daratumumab, in achieving superior responses including progression-free survival (PFS), minimal residual disease (MRD) negativity, objective response rate (ORR), and overall survival (OS) when compared to triple-drug regimens. As treatment regimens evolve with additional agents, the improved outcomes with treatment-related adverse events should be carefully balanced. This review advocates for a paradigm shift towards quadruple induction therapies for TE NDMM, offers a detailed insight into the current landscape of MM treatment, and reinforces a new standard of care.

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临床试验的启示：基于证据的新诊断符合移植条件的多发性骨髓瘤诱导治疗建议。

多发性骨髓瘤（MM）是一种血液恶性肿瘤，给治疗带来了巨大挑战。本综述综合了关键临床试验的证据，为符合移植条件（TE）、新诊断的多发性骨髓瘤（NDMM）患者的诱导治疗提供指导。我们强调从三药诱导治疗到四药诱导治疗的演变过程，并重点介绍了将单克隆抗体，尤其是 CD38 重组单克隆抗体药物纳入治疗方案的情况。这项分析包括对 2010 年至 2023 年期间主要数据库和会议中的研究进行的全面文献综述，最终对 47 项研究进行了详细评估。研究结果强调了四联疗法在TE NDMM中的优越性，尤其是那些纳入达拉单抗的疗法，与三联疗法相比，四联疗法在获得包括无进展生存期（PFS）、最小残留病（MRD）阴性、客观反应率（ORR）和总生存期（OS）在内的优越反应方面更具优势。随着更多药物的加入，治疗方案也在不断发展，因此应谨慎权衡治疗效果的改善与治疗相关不良事件之间的关系。本综述倡导TE NDMM向四联诱导疗法的模式转变，详细介绍了MM治疗的现状，并强化了新的治疗标准。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Antibodies IMMUNOLOGY-

CiteScore

7.10

自引率

6.40%

发文量

审稿时长

11 weeks

期刊介绍： Antibodies (ISSN 2073-4468), an international, peer-reviewed open access journal which provides an advanced forum for studies related to antibodies and antigens. It publishes reviews, research articles, communications and short notes. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. Full experimental and/or methodical details must be provided. Electronic files or software regarding the full details of the calculation and experimental procedure - if unable to be published in a normal way - can be deposited as supplementary material. This journal covers all topics related to antibodies and antigens, topics of interest include (but are not limited to): antibody-producing cells (including B cells), antibody structure and function, antibody-antigen interactions, Fc receptors, antibody manufacturing antibody engineering, antibody therapy, immunoassays, antibody diagnosis, tissue antigens, exogenous antigens, endogenous antigens, autoantigens, monoclonal antibodies, natural antibodies, humoral immune responses, immunoregulatory molecules.