New therapies in multiple myeloma: benefits and limitations

Abstract

Multiple myeloma (MM) is a bone marrow cancer caused by clonal proliferation of plasma cells, and it is classified as a plasma cell dyscrasia. Over the last 20 years, there has been a dramatic increase in the availability of new therapies for patients with MM with a significant improvement in remission duration and overall survival. Introduction of immunomodulatory drugs (thalidomide, lenalidomide, pomalidomide), monoclonal antibodies (eg, daratumumab), and proteasome inhibitors (bortezomib, karflizomib) into the treatment paradigm has meaningfully and favorably changed the prognosis for MM patients. More recently, development of molecular‑targeted therapies, especially bispecific antibodies nd chimeric antigen receptor (CAR)-T cells as part of immunotherapy has rapidly evolved into their use in clinical practice. This review provides an overview of emerging molecular‑targeted therapies for MM, highlighting bispecific antibodies and CAR T‑cell approaches, and examining key structural and functional considerations, principal findings from current clinical trials, and strategies for managing therapy‑related toxicities.