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Review
. 2023 Mar 23;15(7):1929.
doi: 10.3390/cancers15071929.

30 Years of Improved Survival in Non-Transplant-Eligible Newly Diagnosed Multiple Myeloma

Aurelia Chacon  1 , Xavier Leleu  1   2 , Arthur Bobin  1   2
Affiliations
Review

30 Years of Improved Survival in Non-Transplant-Eligible Newly Diagnosed Multiple Myeloma

Aurelia Chacon et al. Cancers (Basel). .

Abstract

The treatment of multiple myeloma (MM) has greatly evolved these past few years. Recent advances in therapeutics have largely benefited elderly patients now renamed "non-transplant-eligible" (NTE) patients. Since the 1960s, and for several decades, chemotherapy was the only treatment for MM. Then, the field was marked by the emergence of targeted therapies in the 2000s, such as immunomodulating agents (thalidomide, lenalidomide, and pomalidomide) and proteasome inhibitors (bortezomib, carfilzomib, and ixazomib), which were the first steps towards an increase in survival. Thereafter, the apparition of monoclonal antibodies (mAbs) was considered a milestone in the treatment of MM for both transplant-eligible and NTE patients. Anti-CD38 mAbs can be safely administered to older patients with an impressive efficacy leading to a never-achieved-before survival rate with the triple association of anti-CD38 mAbs, lenalidomide, and dexamethasone. However, progress is still expected with the introduction in the armamentarium for NTE patients of the most recent innovative immunotherapy-based treatments newly introduced in MM, e.g., CAR-T cells and bispecific antibodies. These "improved versions" of immune-based treatments will probably also benefit NTE patients, although further studies will be needed to better understand their role in this population.

Keywords: CAR-Ts; bispecific antibodies; elderly; immunotherapy; monoclonal antibodies; multiple myeloma; non-transplant-eligible.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Overview of median PFS in NTE NDMM phase 3 clinical trials.
See this image and copyright information in PMC

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