Guest Edtor: Pellegrino Musto NOVELTIES ON MULTIPLE MYELOMA FROM THE MAIN 2024 HEMATOLOGY CONFERENCES

Abstract

Despite the introduction of several therapies in recent years, multiple myeloma (MM) remains a difficult to treat haematological malignancy due to its extreme inter- and intra-patient heterogeneity. However, at the 2024 major international conferences, very significant data have emerged on new approaches that can improve outcomes even in high-risk or very advanced disease. Up-front quadruplet combinations including anti-CD38 monoclonal antibodies proved to be the best therapy in terms of depth of response and long-term efficacy in both transplant eligible and not eligible patients with MRD assessment that could play a key role in determining the duration of therapy avoiding unnecessary overtreatment. However, also quadruplets fail to overcome negative prognostic value of high risk cytogenetics or circulating tumor cells therefore in patients with these features alternative approaches will have to be evaluated. Moreover, considering that not all patients, particularly older and frail ones, will be able to undergo such therapies, it will be necessary to refine the ability to identify the most appropriate therapy for each patient. Bispecific antibodies and CAR-T cells represent the new frontier in the treatment of advanced MM but they have shown even more efficacy with less toxicity in early relapses and in functional high-risk patients. Extremely promising are the results obtained with the inclusion of novel immunotherapies in the upfront setting. In relapsed/refractory MM patients agents as belantamab mafodotin and CELMoDs, in combination with proteasome inhibitors or immunomodulatory agents, will probably represent another valid option.