The introduction of new agents and management strategies over the past decade has resulted in a major step change in treatment outcomes with deepening responses and increased survival for patients with multiple myeloma. In daily clinical practice, healthcare professionals are now faced with challenges including, optimal treatment sequencing and changing treatment goals. In light of this, a group of experts met to discuss diagnostic and treatment guidelines, examine current clinical practice, and consider how new clinical trial data may be integrated into the management of multiple myeloma in the future.

3rd Department of Internal Medicine Semmelweis University Budapest Hungary

Ankara University School of Medicine Ankara Turkey

Assuta Ashdod University Hospital Faculty of Health Science Ben Gurion University of the Negev Negev Israel

Cancer Institute University College London London United Kingdom

Clínica Universidad de Navarra CIMA CIBERONC IDISNA Pamplona Spain

Complejo Asistencial Universitario de Salamanca Instituto de Investigación Biomédica de Salamanca Salamanca Spain

Department of Hematology Erasmus MC Cancer Institute Rotterdam The Netherlands

Department of Hematology Skåne University Hospital und Lund University Lund Sweden

Department of Hematology VU University Medical Center Amsterdam The Netherlands

Department of Hematooncology University Hospital Ostrava and Faculty of Medicine University of Ostrava Ostrava Czech Republic

Department of Internal Medicine 5 University Clinic Heidelberg and National Center of Tumor Diseases Heidelberg Germany

Department of Internal Medicine American University of Beirut Beirut Lebanon

Galway University Hospital Galway Ireland

Hospital and University Centre of Coimbra Coimbra Portugal

Institut d'Investigac'ons Biomedques August Pi Sunyer Barcelona Spain

Institute of Hematology and Transfusion Medicine Warsaw Poland

Klinikum Schwabing München Germany

National Research Center for Hematology of the Ministry of Healthcare of the Russian Federation Moscow Russia

School of Medicine National and Kapodistrian University of Athens Athens Greece

Seràgnoli Institute of Hematology Bologna University School of Medicine Bologna Italy

Service des Maladies du Sang Hôpital Claude Huriez Lille France

University Clinical Center Ljubljana and Medical Faculty Ljubljana Slovenia

University Hospital Leuven Leuven Belgium

University of Nantes Nantes France

University of Torino Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino Turin Italy

Vejle Hospital and University of Southern Denmark Vejle Denmark

Wilhelminen Cancer Research Institute Wilhelminenspital Vienna Austria

Zobrazit více v PubMed

Fonseca R, Abouzaid S, Bonafede M, et al. Trends in overall survival and costs of multiple myeloma, 2000–2014. Leukemia. 2017;31:1915–1921. PubMed PMC

Kumar SK, Dispenzieri A, Lacy MQ, et al. Continued improvement in survival in multiple myeloma: changes in early mortality and outcomes in older patients. Leukemia. 2014;28:1122–1128. PubMed PMC

Usmani SZ, Crowley J, Hoering A, et al. Improvement in long-term outcomes with successive Total Therapy trials for multiple myeloma: are patients now being cured? Leukemia. 2013;27:226–232. PubMed PMC

Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014;15:e538–e548. PubMed

Levey AS, Coresh J, Greene T, et al. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006;145:247–254. PubMed

Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150:604–612. PubMed PMC

Terpos E, Kleber M, Engelhardt M, et al. European Myeloma Network guidelines for the management of multiple myeloma-related complications. Haematologica. 2015;100:1254–1266. PubMed PMC

Hillengass J, Moulopoulos LA, Delorme S, et al. Whole-body computed tomography versus conventional skeletal survey in patients with multiple myeloma: a study of the International Myeloma Working Group. Blood Cancer J. 2017;7:e599. PubMed PMC

Kumar S, Paiva B, Anderson KC, et al. International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma. Lancet Oncol. 2016;17:e328–e346. PubMed

Palumbo A, Avet-Loiseau H, Oliva S, et al. Revised international staging system for multiple myeloma: a report from International Myeloma Working Group. J Clin Oncol. 2015;33:2863–2869. PubMed PMC

Sonneveld P, Avet-Loiseau H, Lonial S, et al. Treatment of multiple myeloma with high-risk cytogenetics: a consensus of the International Myeloma Working Group. Blood. 2016;127:2955–2962. PubMed PMC

Engelhardt M, Dold SM, Ihorst G, et al. Geriatric assessment in multiple myeloma patients: validation of the International Myeloma Working Group (IMWG) score and comparison with other common comorbidity scores. Haematologica. 2016;101:1110–1119. PubMed PMC

Palumbo A, Bringhen S, Mateos MV, et al. Geriatric assessment predicts survival and toxicities in elderly myeloma patients: an International Myeloma Working Group report. Blood. 2015;125:2068–2074. PubMed PMC

Ravindran A, Bartley AC, Holton SJ, et al. Prevalence, incidence and survival of smoldering multiple myeloma in the United States. Blood Cancer J. 2016;6:e486. PubMed PMC

Kristinsson SY, Holmberg E, Blimark C. Treatment for high-risk smoldering myeloma. N Engl J Med. 2013;369:1762–1763. PubMed

Kyle RA, Remstein ED, Therneau TM, et al. Clinical course and prognosis of smoldering (asymptomatic) multiple myeloma. N Engl J Med. 2007;356:2582–2590. PubMed

Perez-Persona E, Vidriales MB, Mateo G, et al. New criteria to identify risk of progression in monoclonal gammopathy of uncertain significance and smoldering multiple myeloma based on multiparameter flow cytometry analysis of bone marrow plasma cells. Blood. 2007;110:2586–2592. PubMed

Fernandez de Larrea C, Isola I, Pereira A, et al. Evolving M-protein pattern in patients with smoldering multiple myeloma: impact on early progression. Leukemia. 2018;32:1427–1434. PubMed

Moreau P, San Miguel J, Sonneveld P, et al. Multiple myeloma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017;28 suppl 4:iv52–iv61. PubMed

Mateos MV, Hernandez MT, Giraldo P, et al. Lenalidomide plus dexamethasone versus observation in patients with high-risk smouldering multiple myeloma (QuiRedex): long-term follow-up of a randomised, controlled, phase 3 trial. Lancet Oncol. 2016;17:1127–1136. PubMed

Mateos MV, Hernandez MT, Giraldo P, et al. Lenalidomide plus dexamethasone for high-risk smoldering multiple myeloma. N Engl J Med. 2013;369:438–447. PubMed

Korde N, Roschewski M, Zingone A, et al. Treatment with carfilzomib-lenalidomide-dexamethasone with lenalidomide extension in patients with smoldering or newly diagnosed multiple myeloma. JAMA Oncol. 2015;1:746–754. PubMed PMC

Ghobrial IM, Liu C-J, Badros A, et al. Initial results of the phase II trial of combination of elotuzumab, lenalidomide, and dexamethasone in high-risk smoldering multiple myeloma. Blood. 2016;128:976.

Hofmeister C, Chari A, Cohen Y, et al. Daratumumab monotherapy for patients with intermediate or high-risk smoldering multiple myeloma (SMM): CENTAURUS, a randomized, open-label, multicenter phase 2 study. Blood. 2017;130 suppl 1:510. PubMed PMC

Brighton T, Harrison SJ, Ghez D, et al. A phase 2, randomized, double-blind, placebo-controlled, multicenter study of siltuximab (anti IL-6 monoclonal antibody) in patients with high-risk smoldering multiple myeloma. Blood. 2017;130 suppl 1:3155.

clinicaltrials.gov. Identifier: NCT02415413. Available at: https://clinicaltrials.gov/ct2/show/NCT02415413 Accessed May 2018.

clinicaltrials.gov. Identifier: NCT03289299. Available at: https://clinicaltrials.gov/ct2/show/NCT03289299 Accessed May 2018.

Mateos MV, Mtez J, Rodríguez P, et al. CurativE StrAtegy for high-Risk Smouldering Myeloma (GEM-CESAR): carfilzomib, lenalidomide and dexamethasone (KRd) as induction followed by HDT-ASCT, consolidation with KRd and maintenance with Rd. Blood. 2017;130 suppl 1:402.

Rosinol L, Oriol A, Rios R, et al. Bortezomib, lenalidomide and dexamethasone (VRD-GEM) as induction therapy prior autologous stem cell transplantation (ASCT) in multiple myeloma (MM): results of a prospective phase III pethema/GEM trial. Blood. 2017;130 suppl 1:2017.

Roussel M, Lauwers-Cances V, Robillard N, et al. Front-line transplantation program with lenalidomide, bortezomib, and dexamethasone combination as induction and consolidation followed by lenalidomide maintenance in patients with multiple myeloma: a phase II study by the Intergroupe Francophone du Myelome. J Clin Oncol. 2014;32:2712–2717. PubMed

Gay FM, Scalabrini DR, Belotti A, et al. Carfilzomib-lenalidomide-dexamethasone (KRd) vs carfilzomib-cyclophosphamide-dexamethasone (KCd) induction: planned interim analysis of the randomized FORTE trial in newly diagnosed multiple myeloma (NDMM). J Clin Oncol. 2017;35 (15 suppl):412s.8003.

Wester R, van der Holt B, Asselbergs E, et al. Carfilzomib combined with thalidomide and low-dose dexamethasone for remission induction and consolidation in newly diagnosed, transplant eligible patients with multiple myeloma: the carthadex trial. Blood. 2017;130 suppl 1:3141. PubMed PMC

Pawlyn C, Davies F, Cairns D, et al. Quadruplet vs sequential triplet induction therapy for myeloma patients: results of the Myeloma XI study. EHA Learning Center. 2017;181694:S407.Available at: https://learningcenter.ehaweb.org/eha/2017/22nd/181694/charlotte.pawlyn.quadruplet.vs.sequential.triplet.induction.therapy.for.html. Accessed May 2018

Moreau P, Hulin C, Caillot D, et al. Ixazomib-lenalidomide-dexamethasone (IRd) combination before and after autologous stem cell transplantation (ASCT) followed by ixazomib maintenance is a safe and effective strategy in patients with newly diagnosed multiple myeloma (NDMM): a phase 2 study from the Intergroupe Francophone Du MyéLome (IFM). Blood. 2017;130 suppl 1:2021.

clinicaltrials.gov. Identifier: NCT02541383. Available at: https://clinicaltrials.gov/ct2/show/NCT02541383 Accessed May 2018.

Cavo M, Hájek R, Pantani L, et al. Autologous stem cell transplantation versus bortezomib-melphalan-prednisone for newly diagnosed multiple myeloma: second interim analysis of the phase 3 EMN02/HO95 study. Blood. 2017;130 suppl 1:397. PubMed

Attal M, Lauwers-Cances V, Hulin C, et al. Lenalidomide, bortezomib, and dexamethasone with transplantation for myeloma. N Engl J Med. 2017;376:1311–1320. PubMed PMC

Cavo M, Gay F, Patriarca F, et al. Double autologous stem cell transplantation significantly prolongs progression-free survival and overall survival in comparison with single autotransplantation in newly diagnosed multiple myeloma: an analysis of phase 3 EMN02/HO95 study. Blood. 2017;130 suppl 1:401.

Sonneveld P, Beksac M, van der Holt B, et al. Consolidation followed by maintenance therapy versus maintenance alone in newly diagnosed, transplant eligible patients with multiple myeloma (MM): a randomized phase 3 study of the European Myeloma Network (EMN02/HO95 MM trial). Blood. 2016;128:242.

Stadtmauer EA, Pasquini MC, Blackwell B, et al. Comparison of autologous hematopoietic cell transplant (autoHCT), bortezomib, lenalidomide (len) and dexamethasone (RVD) consolidation with len maintenance (ACM), tandem autohct with len maintenance (TAM) and autohct with len maintenance (AM) for up-front treatment of patients with multiple myeloma (MM): primary results from the randomized phase III trial of the Blood and Marrow Transplant Clinical Trials Network (BMT CTN 0702—StaMINA trial). Blood. 2016;128: LBA-1.

Einsele H, Knop S, Vogel M, et al. Response-adapted consolidation with bortezomib after ASCT improves progression-free survival in newly diagnosed multiple myeloma. Leukemia. 2017;31:1463–1466. PubMed

Mellqvist UH, Gimsing P, Hjertner O, et al. Bortezomib consolidation after autologous stem cell transplantation in multiple myeloma: a Nordic Myeloma Study Group randomized phase 3 trial. Blood. 2013;121:4647–4654. PubMed PMC

Sezer O, Beksac M, Hajek R, et al. Effects of single-agent bortezomib as post-transplant consolidation therapy on multiple myeloma-related bone disease: a randomized phase II study. Br J Haematol. 2017;178:61–71. PubMed

Cavo M, Pantani L, Petrucci MT, et al. Bortezomib-thalidomide-dexamethasone is superior to thalidomide-dexamethasone as consolidation therapy after autologous hematopoietic stem cell transplantation in patients with newly diagnosed multiple myeloma. Blood. 2012;120:9–19. PubMed

McCarthy PL, Holstein SA, Petrucci MT, et al. Lenalidomide maintenance after autologous stem-cell transplantation in newly diagnosed multiple myeloma: a meta-analysis. J Clin Oncol. 2017;35:3279–3289. PubMed PMC

Jackson G, Davies FE, Pawlyn C, et al. Lenalidomide maintenance significantly improves outcomes compared to observation irrespective of cytogenetic risk: results of the Myeloma XI trial. Blood. 2017;130 suppl 1:436.

Sonneveld P, Schmidt-Wolf IG, van der Holt B, et al. Bortezomib induction and maintenance treatment in patients with newly diagnosed multiple myeloma: results of the randomized phase III HOVON-65/GMMG-HD4 trial. J Clin Oncol. 2012;30:2946–2955. PubMed

Goldschmidt H, Lokhorst HM, Mai EK, et al. Bortezomib before and after high-dose therapy in myeloma: long-term results from the phase III HOVON-65/GMMG-HD4 trial. Leukemia. 2018;32:383–390. PubMed

Rosinol L, Oriol A, Teruel AI, et al. Bortezomib and thalidomide maintenance after stem cell transplantation for multiple myeloma: a PETHEMA/GEM trial. Leukemia. 2017;31:1922–1927. PubMed

Celgene Europe Ltd. Revlimid EU SmPC. 2017. Available at: https://www.ema.europa.eu/documents/product-information/revlimid-epar-product-information_en.pdf Accessed May 2018.

Mateos MV, Martinez-Lopez J, Hernandez MT, et al. Sequential vs alternating administration of VMP and Rd in elderly patients with newly diagnosed MM. Blood. 2016;127:420–425. PubMed

Mateos M, Martínez-López J, Hernández JM, et al. Depth of response as surrogate marker for progression-free survival and overall survival in elderly newly diagnosed myeloma patients treated with VMP and Rd: GEM2010MAS65. EHA Learning Center. 2017;181696:S409.Available at: https://learningcenter.ehaweb.org/eha/2017/22nd/181696/mara-victoria.mateos.depth.of.response.as.surrogate.marker.for.html. Accessed May 2018

Mateos MV, Oriol A, Martinez-Lopez J, et al. Maintenance therapy with bortezomib plus thalidomide or bortezomib plus prednisone in elderly multiple myeloma patients included in the GEM2005MAS65 trial. Blood. 2012;120:2581–2588. PubMed

clinicaltrials.gov. Identifier: NCT02312258. Available at: https://clinicaltrials.gov/ct2/show/NCT02312258. Accessed May 2018.

Palumbo A, Hajek R, Delforge M, et al. Continuous lenalidomide treatment for newly diagnosed multiple myeloma. N Engl J Med. 2012;366:1759–1769. PubMed

Dimopoulos MA, Facon T, Richardson PGG, et al. ELOQUENT-1: a phase III, randomized, open-label trial of lenalidomide/dexamethasone with or without elotuzumab in subjects with previously untreated multiple myeloma (CA204-006). J Clin Oncol. 2012;30 (15 suppl): TPS8113.

Richardson PG, Kumar S, Laubach JP, et al. New developments in the management of relapsed/refractory multiple myeloma—the role of ixazomib. J Blood Med. 2017;8:107–121. PubMed PMC

Facon T, Cavo M, Jakubowiak A, et al. Two randomized open-label studies of daratumumab (DARA) plus standard of care treatment versus standard of care alone in patients with previously untreated multiple myeloma (MM) ineligible for high-dose therapy: 54767414MMY3007 (Alcyone) and 54767414MMY3008 (Maia). Clin Lymphoma Myeloma Leuk 15:e294–e295.

Zweegman S, van der Holt B, Schjesvold FH, et al. Ixazomib-thalidomide-low dose dexamethasone (ITd) induction followed by maintenance therapy with ixazomib or placebo in newly diagnosed multiple myeloma patients not eligible for autologous stem cell transplantation; initial results from the randomized phase II HOVON-126/Nmsg 21.13 trial. Blood. 2017;130 suppl 1:433. PubMed PMC

Mateos MV, Dimopoulos MA, Cavo M, et al. Daratumumab plus bortezomib, melphalan, and prednisone for untreated myeloma. N Engl J Med. 2018;378:518–528. PubMed

Facon T, Dimopoulos MA, Dispenzieri A, et al. Final analysis of survival outcomes in the phase 3 FIRST trial of up-front treatment for multiple myeloma. Blood. 2018;131:301–310. PubMed PMC

Bredella MA, Steinbach L, Caputo G, et al. Value of FDG PET in the assessment of patients with multiple myeloma. AJR Am J Roentgenol. 2005;184:1199–1204. PubMed

Bartel TB, Haessler J, Brown TL, et al. F18-fluorodeoxyglucose positron emission tomography in the context of other imaging techniques and prognostic factors in multiple myeloma. Blood. 2009;114:2068–2076. PubMed PMC

Dimopoulos MA, White D, Benboubker L, et al. Daratumumab, lenalidomide, and dexamethasone (DRd) versus lenalidomide and dexamethasone (Rd) in relapsed or refractory multiple myeloma (RRMM): updated efficacy and safety analysis of POLLUX. Blood. 2017;130 suppl 1:739.

Stewart AK, Rajkumar SV, Dimopoulos MA, et al. Carfilzomib, lenalidomide, and dexamethasone for relapsed multiple myeloma. N Engl J Med. 2015;372:142–152. PubMed

Stewart AK, Siegel D, Ludwig H, et al. Overall survival (OS) of patients with relapsed/refractory multiple myeloma (RRMM) treated with carfilzomib, lenalidomide, and dexamethasone (KRd) versus lenalidomide and dexamethasone (Rd): final analysis from the randomized phase 3 ASPIRE trial. Blood. 2017;130 suppl 1:743.

Moreau P, Masszi T, Grzasko N, et al. Oral ixazomib, lenalidomide, and dexamethasone for multiple myeloma. N Engl J Med. 2016;374:1621–1634. PubMed

Dimopoulos MA, Lonial S, White D, et al. Elotuzumab plus lenalidomide/dexamethasone for relapsed or refractory multiple myeloma: ELOQUENT-2 follow-up and post-hoc analyses on progression-free survival and tumour growth. Br J Haematol. 2017;178:896–905. PubMed PMC

Spencer A, Hungria V, Mateos MV, et al. Daratumumab, bortezomib, and dexamethasone (DVd) versus bortezomib and dexamethasone (Vd) in relapsed or refractory multiple myeloma (RRMM): updated efficacy and safety analysis of CASTOR. Blood. 2017;130 suppl 1:3145.

San-Miguel JF, Hungria VT, Yoon SS, et al. Panobinostat plus bortezomib and dexamethasone versus placebo plus bortezomib and dexamethasone in patients with relapsed or relapsed and refractory multiple myeloma: a multicentre, randomised, double-blind phase 3 trial. Lancet Oncol. 2014;15:1195–1206. PubMed

Richardson PG, Hungria VT, Yoon SS, et al. Panobinostat plus bortezomib and dexamethasone in previously treated multiple myeloma: outcomes by prior treatment. Blood. 2016;127:713–721. PubMed PMC

San-Miguel JF, Hungria VT, Yoon SS, et al. Overall survival of patients with relapsed multiple myeloma treated with panobinostat or placebo plus bortezomib and dexamethasone (the PANORAMA 1 trial): a randomised, placebo-controlled, phase 3 trial. Lancet Haematol. 2016;3:e506–e515. PubMed

Jakubowiak A, Offidani M, Pegourie B, et al. Randomized phase 2 study: elotuzumab plus bortezomib/dexamethasone vs bortezomib/dexamethasone for relapsed/refractory MM. Blood. 2016;127:2833–2840. PubMed PMC

Dimopoulos MA, Moreau P, Palumbo A, et al. Carfilzomib and dexamethasone versus bortezomib and dexamethasone for patients with relapsed or refractory multiple myeloma (ENDEAVOR): a randomised, phase 3, open-label, multicentre study. Lancet Oncol. 2016;17:27–38. PubMed

Dimopoulos MA, Goldschmidt H, Niesvizky R, et al. Carfilzomib or bortezomib in relapsed or refractory multiple myeloma (ENDEAVOR): an interim overall survival analysis of an open-label, randomised, phase 3 trial. Lancet Oncol. 2017;18:1327–1337. PubMed

Kumar S, Mahmood ST, Lacy MQ, et al. Impact of early relapse after auto-SCT for multiple myeloma. Bone Marrow Transplant. 2008;42:413–420. PubMed

Jimenez-Zepeda VH, Mikhael J, Winter A, et al. Second autologous stem cell transplantation as salvage therapy for multiple myeloma: impact on progression-free and overall survival. Biol Blood Marrow Transplant. 2012;18:773–779. PubMed

Baz RC, Martin TG, III, Lin HY, et al. Randomized multicenter phase 2 study of pomalidomide, cyclophosphamide, and dexamethasone in relapsed refractory myeloma. Blood. 2016;127:2561–2568. PubMed

Richardson PG, Hofmeister CC, Raje NS, et al. Pomalidomide, bortezomib and low-dose dexamethasone in lenalidomide-refractory and proteasome inhibitor-exposed myeloma. Leukemia. 2017;31:2695–2701. PubMed PMC

clinicaltrials.gov. Identifier: NCT01734928. Available at: https://clinicaltrials.gov/ct2/show/NCT01734928 Accessed May 2018.

Mikhael J, Richardson P, Usmani S, et al. A phase 1b study of isatuximab plus pomalidomide (Pom) and dexamethasone (Dex) in relapsed/refractory multiple myeloma (RRMM). EHA Learning Center. 2017;181744:S457.Available at: https://learningcenter.ehaweb.org/eha/2017/22nd/181744/joseph.mikhael.a.phase.ib.study.of.isatuximab.plus.pomalidomide.28pom29.and.html. Accessed May 2018

Richardson PG, Attal M, Campana F, et al. Isatuximab plus pomalidomide/dexamethasone versus pomalidomide/dexamethasone in relapsed/refractory multiple myeloma: ICARIA Phase III study design. Future Oncol. 2017;14:1035–1047. PubMed

Chari A, Suvannasankha A, Fay JW, et al. Daratumumab plus pomalidomide and dexamethasone in relapsed and/or refractory multiple myeloma. Blood. 2017;130:974–981. PubMed PMC

Terpos E, Dimopoulos MA, Kastritis E, et al. A multicenter, randomized, phase 3 study of pomalidomide and dexamethasone (Pom-dex) with or without daratumumab in patients with relapsed or refractory multiple myeloma. Ann Oncol. 2017;28 suppl 5:368.1035TiP. PubMed

Usmani SZ, Nahi H, Weiss BM, et al. Safety and efficacy of daratumumab monotherapy in patients with heavily pretreated relapsed and refractory multiple myeloma: final results from GEN501 and Sirius. Blood. 2017;130 suppl 1:3107.

Martin T, Baz R, Benson DM, et al. A phase 1b study of isatuximab plus lenalidomide and dexamethasone for relapsed/refractory multiple myeloma. Blood. 2017;129:3294–3303. PubMed PMC

Dimopoulos MA, Oriol A, Nahi H, et al. Daratumumab, lenalidomide, and dexamethasone for multiple myeloma. N Engl J Med. 2016;375:1319–1331. PubMed

Palumbo A, Chanan-Khan A, Weisel K, et al. Daratumumab, bortezomib, and dexamethasone for multiple myeloma. N Engl J Med. 2016;375:754–766. PubMed

Moreau P, Chanan-Khan A, Roberts AW, et al. Promising efficacy and acceptable safety of venetoclax plus bortezomib and dexamethasone in relapsed/refractory MM. Blood. 2017;130:2392–2400. PubMed

Vogl DT, Dingli D, Cornell RF, et al. Selinexor and low dose dexamethasone (Sd) in patients with lenalidomide, pomalidomide, bortezomib, carfilzomib and anti-CD38 Ab refractory multiple myeloma (MM): STORM study. Blood. 2016;128:491.

Bahlis NJ, Sutherland H, White D, et al. Selinexor in combination with weekly low dose bortezomib and dexamethasone (SVd) induces a high response rate with durable responses in patients with refractory multiple myeloma (MM). Blood. 2017;130 suppl 1:3135.

clinicaltrials.gov. Identifier: NCT03110562. Available at: https://clinicaltrials.gov/ct2/show/NCT03110562 Accessed October 2017.

Badros A, Hyjek E, Ma N, et al. Pembrolizumab, pomalidomide, and low-dose dexamethasone for relapsed/refractory multiple myeloma. Blood. 2017;130:1189–1197. PubMed

Ocio EM, Mateos MV, Orlowski RZ, et al. Pembrolizumab (Pembro) plus lenalidomide (Len) and low-dose dexamethasone (Dex) for relapsed/refractory multiple myeloma (RRMM): Efficacy and biomarker analyses. J Clin Oncol. 2017;35 (15 suppl):8015–18015.

U.S. Food and Drug Adminstration. FDA Alerts Healthcare Professionals and Oncology Clinical Investigators about Two Clinical Trials on Hold Evaluating KEYTRUDA® (pembrolizumab) in Patients with Multiple Myeloma. 2017; Available at: https://www.fda.gov/Drugs/DrugSafety/ucm574305.htm Accessed May 2018.

Wolska-Washer A, Robak P, Smolewski P, et al. Emerging antibody-drug conjugates for treating lymphoid malignancies. Expert Opin Emerg Drugs. 2017;22:259–273. PubMed

Danhof S, Hudecek M, Smith EL. CARs and other T cell therapies for MM: the clinical experience. Best Pract Res Clin Haematol. 2018;31:147–157. PubMed PMC

Ali SA, Shi V, Maric I, et al. T cells expressing an anti-B-cell maturation antigen chimeric antigen receptor cause remissions of multiple myeloma. Blood. 2016;128:1688–1700. PubMed PMC

Berdeja JG, Lin Y, Raje N, et al. Durable clinical responses in heavily pretreated patients with relapsed/refractory multiple myeloma: updated results from a multicnter study of bb2121 anti-BCMA CAR T cell therapy. Blood. 2017;130 suppl 1:740.

Cohen AD, Garfall AL, Stadtmauer EA, et al. B-cell maturation antigen (BCMA)-specific chimeric antigen receptor T cells (CART-BCMA) for multiple myeloma (MM): initial safety and efficacy from a phase 1 study. Blood. 2016;128:1147.

Trudel S, Lendvai N, Popat R, et al. Deep and durable responses in patients (pts) with relapsed/refractory multiple myeloma (MM) treated with monotherapy GSK2857916, an antibody drug conjugate against B-cell maturation antigen (BCMA): preliminary results from part 2 of study BMA117159. Blood. 2017;130 suppl 1:741.

Daratumumab with lenalidomide and dexamethasone in relapsed or refractory multiple myeloma patients - real world evidence analysis