Current strategies for treatment of relapsed/refractory multiple myeloma

Expert Rev Hematol. 2014 Feb;7(1):97-111. doi: 10.1586/17474086.2014.882764. Epub 2014 Jan 29.


In spite of significant advances in the management of multiple myeloma (MM), the disease remains incurable and nearly all patients ultimately relapse and require salvage chemotherapy. As such, relapsed and relapsed-refractory MM remains a critical area of research pertaining to biological mechanisms of progression and chemotherapy resistance, as well as to the development of new pharmacologic agents and immunologic approaches for the disease. The immunomodulatory agents and proteasome inhibitors represent the cornerstone of treatment in this setting, with combination regimens incorporating these drugs demonstrating encouraging rates and duration of response, including the newer agents, pomalidomide and carfilzomib. In addition, novel drug classes have shown promising activity in RR MM, including the orally-administered proteasome inhibitors ixazomib and oprozomib; monoclonal antibodies such as the anti-CS1 monoclonal antibody elotuzumab and anti-CD38 monoclonal antibody daratumumab; and histone deacetylase inhibitors such as panobinostat and rocilinostat.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Antibodies, Monoclonal / therapeutic use
  • Drug Therapy, Combination
  • Histone Deacetylase Inhibitors / therapeutic use
  • Humans
  • Immunologic Factors / therapeutic use*
  • Multiple Myeloma / therapy*
  • Proteasome Inhibitors / therapeutic use*
  • Recurrence
  • Salvage Therapy
  • Stem Cell Transplantation


  • Adrenal Cortex Hormones
  • Antibodies, Monoclonal
  • Histone Deacetylase Inhibitors
  • Immunologic Factors
  • Proteasome Inhibitors