[Novel therapeutic approaches for multiple myeloma].

Abstract

Multiple myeloma has conventionally been treated with three major classes of drugs, including immunomodulatory drugs, proteasome inhibitors and anti-CD38 antibodies, but T-cell redirection therapies (CAR-T cell therapy and bispecific antibodies) targeting B-cell maturation antigen (BCMA), which is highly expressed on the surface of myeloma cells, have now been adopted as a new modality. In Japan, CAR-T therapy is indicated as a third-line treatment for patients who have already received three classes of drugs, and bispecific antibodies are also indicated for patients who have already received three lines of therapy. Regimens combining antibody-drug conjugates targeting BCMA with bortezomib or pomalidomide have also demonstrated efficacy. GPRC5D is also attracting attention as a new target, and bispecific antibodies should soon become available for clinical use. Although these are very effective treatments, they are not curative. Therefore, determining how to sequence conventional treatments (combinations of the three classes) and these new treatments will be an important clinical challenge.