Management of Relapsed/Refractory Multiple Myeloma

Abstract

The treatment of relapsed multiple myeloma is based in part on the degree of previous exposure and resistance to commonly used drug classes. For patients with a first relapse, an anti-CD38 antibody-based combination is preferred unless patients have already received these agents, in which case a carfilzomib-based option can be an excellent choice. For patients with more refractory disease, a bispecific antibody is an emerging choice, but CAR T-cell therapy should also be considered for some patients; other options include salvage autologous transplantation, recycling of previous therapies, and selinexor-based therapies. Emerging new classes of drugs in development are poised to broaden the treatment possibilities for relapsed disease.