Multiple myeloma (MM) has an evolving therapeutic landscape. Recent innovations highlight the profound impact of immunotherapies and targeted strategies, offering transformative potential for patients with refractory or relapsed disease.
Bispecific Antibodies: Bispecific T-cell engagers (BiTEs) represent a cornerstone of recent advancements in MM management. These agents, such as teclistamab, are engineered to simultaneously bind BCMA on myeloma cells and CD3 on T cells, inducing potent cytotoxicity.1 Early-phase clinical trials report high overall response rates, even in heavily pretreated populations.2 Notably, these therapies address resistance to conventional treatments, positioning them as critical tools for bridging patients to sustained remissions or further novel therapies.
CAR T-Cell Therapies: Chimeric antigen receptor (CAR) T-cell therapies, particularly those targeting B cell maturation antigen (BCMA), have reshaped treatment paradigms for relapsed/refractory MM.3 Studies have demonstrated durable responses in patients with limited options, with ongoing research focused on enhancing persistence, reducing toxicity, and exploring novel antigens.4
Immunomodulatory Agents: Cereblon (CRBN)-targeting immunomodulatory drugs are a foundation in current approaches to MM management. However, emerging therapies like iberdomide represent next-generation immunomodulatory agents with enhanced efficacy and improved safety profiles. These agents are currently undergoing clinical trials.5 Precision medicine approaches targeting specific mutations in MM hold promise, underscoring the growing role of genomics in treatment selection.
Selective Inhibitors of Nuclear Export (SINE): SINEs, such as selinexor, represent a novel class of targeted therapies that interfere with the transport of tumor suppressor proteins. Clinical trials have demonstrated the efficacy of selinexor in relapsed/refractory MM, particularly in combination with dexamethasone and proteasome inhibitors.6,7 Despite notable side effects, such as fatigue and nausea, optimized dosing strategies are improving tolerability and expanding its clinical utility.
For clinicians, the rapid evolution of MM therapeutics demands vigilance in integrating these innovations into clinical practice. These advancements not only enhance survival outcomes but also redefine the therapeutic landscape, offering renewed hope for patients with high-risk disease.
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