Special Issue "How to Treat and Manage Multiple Myeloma in the Era of Ultra-Novel Agents"

Dear Colleagues,

Multiple myeloma (MM) is a malignant neoplasm of plasma cells that accumulate in bone marrow, leading to bone destruction and marrow failure. It accounts for approximately 1.8% of all hematologic and solid cancers and around > 15% of hematologic malignancies in the United States. MM is typically sensitive to different classes of cytotoxic drugs, both as frontline treatment and as treatment for relapsed disease. Unfortunately, even though patient responses are typically durable, nowadays, MM is not considered to b curable with the current approaches.

However, MM survival rates have been improved due to the introduction of novel agents; patients diagnosed after 2010 have higher success rates with novel therapy use and better survival outcomes compared with those diagnosed in earlier years. The most relevant therapeutic advances over the past few decades include the introduction of novel therapies, such as immune-modifying agents (thalidomide and lenalidomide) and proteasome inhibitors (bortezomib), either with or without stem cell transplantation.

Moreover, in the last few years, the MM therapeutic “toolbox” has improved further with the approval of new generation IMID (pomalidomide), monoclonal antibodies, daratumumab and elotuzumab, as well as the new-generation proteasome inhibitors, carfilzomib and ixazomib.

At the same time, our understanding of MM tumor biology is increasing, creating the rationale for new combinations of drugs and new therapy development. Discovery of the associated cytogenetic abnormalities confirm the hypothesis that MM is a heterogeneous disease, suggesting that risk-adapted therapies and individualizing treatment will further us to help improve patient management.

In this scenario, our idea is to evaluate both in newly diagnosed, relapsed/refractory multiple myeloma and supportive care the retrospective experiences of several treatments, including old and novel agents, in order to compare “real world” experiences with clinical trial results.

Data on the efficacy and safety of real-life experiences seem to be highly comparable to those of major trials, adopting the same regimen in the same clinical setting without the limits of the eligibility criteria. This shows how these treatments can be considered as feasible salvage therapeutic options, particularly in heavily pretreated patients.

Moreover, the timing of undergoing ASCT in novel agents-based induction or reinduction, MRD monitoring, and supportive care recommendations in the management of MM with novel agents are other hot topics. We welcome the submission of original research, reviews, clinical trials, hypotheses and theories, in addition to case reports and opinion articles.

Dr. Claudio Cerchione
Guest Editors

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• multiple myeloma
• smoldering myeloma
• novel agents
• monoclonal antibodies
• bispecific antibodies
• IMIDs
• proteosome inhibitors
• patient care
• support and management care