Multiple myeloma: diagnosis and therapy (part 2)

The use of new approaches in the treatment of relapses and refractory forms of multiple myeloma (MM) has led to a significant improvement in the overall survival and progression-free survival of patients, achieving a high-quality and long-term response. These changes are mainly associated with the use of new drugs: proteasome inhibitors, immunomodulatory drugs, monoclonal antibodies, each of which has a pronounced antitumor activity. Currently, the number of drugs that are used in MM is quite large, and their spectrum is increasingly expanding. Nevertheless, the results of treatment of patients with relapsed / refractory forms of MM are not completely satisfactory, which indicates the difficulties of developing effective medicines. A large number of second- and third-generation drugs, monoclonal antibodies, have appeared, which are becoming increasingly available for clinical use. Convincing data on the high efficacy of bispecific antibodies have already been obtained. A new medical technology - CAR-T therapy attracts attention. This review covers the new strategies, based on clinical trials and our own data and intended for optimizing treatment outcomes in relapsed/refractory multiple myeloma. We describe the various classes of novel drugs under investigation and discuss the pros and cons of the data obtained in clinical studies. The adverse effects of the new drugs are presented in detail.