Multiple myeloma (relapsed/refractory)
About
Multiple myeloma is a tumor with malignant proliferation of plasma cells. Although new drugs (immunomodulators, proteasome inhibitors, CD38 monoclonal antibodies) have significantly improved outcomes, almost all patients will eventually relapse and become resistant to existing drugs. Core dilemmas: ① Patients with five-fold drug resistance (lenalidomide, bortezomib, daratumumab, CD38 monoclonal antibody, CAR-T) have a very poor prognosis;② Although BCMA targeted therapy has made breakthroughs, drug resistance and accessibility remain issues.
Features & Symptoms
- Malignant proliferation of plasma cells
- Bone destruction, hypercalcemia
- renal impairment
- Repeated recurrence and ultimately refractory
Treatment Options
| Treatment | Description | Stage | Price Range |
|---|---|---|---|
| BCMA CAR-T cell therapy | Idecabtagene vicleucel (Abecma) and Ciltacabtagene autoleucel (Carvykti) have been approved by the FDA for use in relapsed/refractory MM. | FDA批准 | $400K - $1M/疗程 |
| BCMA-CD3 bispecific antibody | BCMA targeted bispecific antibodies such as Teclistamab and Elranatamab are used in patients who have relapsed after CAR-T treatment or are not suitable for CAR-T. | FDA批准 | $300K - $700K/年 |
| GPRC5D CAR-T/dual antibody | CAR-T and bispecific antibodies targeting GPRC5D provide new options for patients who relapse after BCMA targeted therapy. | Phase II | $350K - $800K/疗程 |
Prognosis
The median survival time of patients with five-fold drug resistance is less than 1 year
Additional Notes
Notes: FISH testing recommendations: It is recommended to perform t(4; 14)、t(14; FISH tests such as 16), del(17p), and 1q21 amplification to assess prognosis; Five-fold drug resistance management: Patients who are resistant to proteasome inhibitors, immunomodulators, anti-CD38 monoclonal antibodies, anti-SLAMF7 monoclonal antibodies and glucocorticoids have extremely poor prognosis, and new therapies need to be considered;CAR-T treatment: Idecabtagene viceucel and Ciltacabtagene autoleucel have been approved for treated multiple myeloma, requiring attention to CRS and neurotoxicity; Bone disease management: Bisphosphonates or denosumab can reduce bone-related events and is recommended once a month; renal function monitoring: Kidney damage is common in myeloma, and renal function needs to be monitored regularly and nephrotoxic drugs avoided. Exclusive service commitment: The platform will allocate a dedicated medical team to each patient to assist in dismantling and properly deploying the following precautions throughout the process. When cross-state and cross-border diagnosis and treatment projects or drugs are involved, the platform will make overall arrangements for the entire docking; for disabled and semi-disabled patient groups, the platform will provide rush-free alternative solutions (including remote consultation, door-to-door sampling, direct drug delivery in the cold chain, etc.), to ensure that patients can get the same high-quality diagnosis and treatment resources without having to travel in person.; Study phase: FDA approval. Prognosis: The median survival time of patients with five-fold drug resistance is less than 1 year.
Frequently Asked Questions
What is Multiple myeloma (relapsed/refractory)?
Multiple myeloma is a tumor with malignant proliferation of plasma cells. Although new drugs (immunomodulators, proteasome inhibitors, CD38 monoclonal antibodies) have significantly improved outcomes, almost all patients will eventually relapse and become resistant to existing drugs. Core dilemmas: ① Patients with five-fold drug resistance (lenalidomide, bortezomib, daratumumab, CD38 monoclonal antibody, CAR-T) have a very poor prognosis;② Although BCMA targeted therapy has made breakthroughs, drug resistance and accessibility remain issues.
What are the symptoms of Multiple myeloma (relapsed/refractory)?
Malignant proliferation of plasma cells,Bone destruction, hypercalcemia,renal impairment,Repeated recurrence and ultimately refractory
How is Multiple myeloma (relapsed/refractory) treated?
BCMA CAR-T cell therapy: Idecabtagene vicleucel (Abecma) and Ciltacabtagene autoleucel (Carvykti) have been approved by the FDA for use in relapsed/refractory MM.; BCMA-CD3 bispecific antibody: BCMA targeted bispecific antibodies such as Teclistamab and Elranatamab are used in patients who have relapsed after CAR-T treatment or are not suitable for CAR-T.; GPRC5D CAR-T/dual antibody: CAR-T and bispecific antibodies targeting GPRC5D provide new options for patients who relapse after BCMA targeted therapy.
What is the prognosis for Multiple myeloma (relapsed/refractory)?
The median survival time of patients with five-fold drug resistance is less than 1 year