first demonstrated the clinical benefit of DARA plus standard of care in TE patients with NDMM, including a better sCR rate (D-VTD 29% vs. In the randomized, open-label, phase 3 CASSIOPEIA trial, Moreau et al. These results support the use of D-RVD, DARA, and lenalidomide in TE NDMM patients. Subgroup analysis showed the superiority of DARA and lenalidomide over placebo for maintenance. Recent updated data showed that the estimated 36-month progression-free survival (PFS) rate was 88.9% and 81.2% for the D-RVD group and RVD group, respectively.
After a median follow-up of 22.1 months, the sCR rates (62.6% vs. 32.0% one-sided P = 0.068) by the end of post-auto-SCT consolidation. The authors observed a higher stringent complete response (sCR) rate for cases in the D-RVD group than that for cases in the RVD group (42.4% vs. In a recent study, 270 TE patients with NDMM were randomized 1:1 to daratumumab (DARA) plus RVD (D-RVD) and RVD groups. Induction TherapyĬurrent guidelines recommend triplet regimens as induction therapy (IT) for TE patients with the addition of an IMiD, such as bortezomib, lenalidomide, and dexamethasone (VRD), bortezomib, thalidomide, and dexamethasone (VTD), and carfilzomib, lenalidomide, and dexamethasone (KRD), which are preferred to cyclophosphamide-containing regimens such as bortezomib, cyclophosphamide, and dexamethasone (VCD), and carfilzomib, cyclophosphamide, and dexamethasone (KCD). In the era of targeted therapies such as BCMA-CD3 bispecific antibody, CAR natural killer (NK) cells, belantamab mafodotin, and venetoclax, auto-SCT remains the standard of care for transplant-eligible (TE) patients with NDMM (Table 1). This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors. We provide an outlook on future prospects and challenges in cellular therapy and note that dealing with relapse, minimal residual disease (MRD)-directed therapy, and combinations of different cellular therapy methods are active research areas in terms of improving prognosis for MM patients. Herein, we discuss the recent advances and challenges of cellular immunotherapies for MM, focusing mainly on auto-SCT, allo-SCT, and CAR T-cell approaches (Tables 1, 2, and 3). Moreover, long-term follow-up has offered preliminary evidence that the existence of the graft-versus-myeloma effect after allogeneic SCT (allo-SCT) can improve outcomes and provide the possibility for curing a subset of patients with newly diagnosed MM (NDMM). In recent years, the introduction of chimeric antigen receptor T-cell (CAR T-cell) therapy has improved the prognosis of refractory and relapsing MM (R/R-MM). At present, patients with MM cannot be cured, although the clinical use of immunomodulatory drugs (IMiD), proteasome inhibitors, cluster of differentiation 38 (CD38)-targeting antibodies, and autologous stem cell transplantation (auto-SCT) has significantly extended survival time. Multiple myeloma (MM) is the second most common hematologic malignancy, responsible for 98,437 deaths globally in 2016.
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