Multiple Myeloma Questions & Answers

1. Dimopoulos M, Kyle R, Fermand JP, Rajkumar SV, San Miguel J, et al. Consensus recommendations for standard investigative workup: report of the International Myeloma Workshop Consensus Panel 3. Blood. 2011 May 5. 117 (18):4701-5. [QxMD MEDLINE Link].

2. [Guideline] National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology, Multiple Myeloma. Available at http://www.nccn.org/professionals/physician_gls/pdf/myeloma.pdf. Version 4.2023 — August 25, 2023; Accessed: September 13, 2023.

3. Rajkumar SV. Myeloma today: Disease definitions and treatment advances. Am J Hematol. 2016 Jan. 91 (1):90-100. [QxMD MEDLINE Link].

4. Palumbo A, Rajkumar SV. Treatment of newly diagnosed myeloma. Leukemia. 2009 Mar. 23(3):449-56. [QxMD MEDLINE Link].

5. Bensinger WI. Role of autologous and allogeneic stem cell transplantation in myeloma. Leukemia. 2009 Mar. 23(3):442-8. [QxMD MEDLINE Link]. [Full Text].

6. van Nieuwenhuijzen N, Spaan I, Raymakers R, Peperzak V. From MGUS to Multiple Myeloma, a Paradigm for Clonal Evolution of Premalignant Cells. Cancer Res. 2018 May 15. 78 (10):2449-2456. [QxMD MEDLINE Link]. [Full Text].

7. Kuehl WM, Bergsagel PL. Molecular pathogenesis of multiple myeloma and its premalignant precursor. J Clin Invest. 2012 Oct. 122 (10):3456-63. [QxMD MEDLINE Link]. [Full Text].

8. Raab MS, Podar K, Breitkreutz I, Richardson PG, Anderson KC. Multiple myeloma. Lancet. 2009 Jul 25. 374(9686):324-39. [QxMD MEDLINE Link].

9. Ludwig H, Drach J, Graf H, Lang A, Meran JG. Reversal of acute renal failure by bortezomib-based chemotherapy in patients with multiple myeloma. Haematologica. 2007 Oct. 92(10):1411-4. [QxMD MEDLINE Link].

10. Zucchelli P, Pasquali S, Cagnoli L, Ferrari G. Controlled plasma exchange trial in acute renal failure due to multiple myeloma. Kidney Int. 1988 Jun. 33(6):1175-80. [QxMD MEDLINE Link].

11. What Causes Multiple Myeloma?. American Cancer Society. Available at https://www.cancer.org/cancer/multiple-myeloma/causes-risks-prevention/what-causes.html. February 28, 2018; Accessed: January 13, 2023.

12. Koutros S, Baris D, Bell E, Zheng T, Zhang Y, Holford TR, et al. Use of hair colouring products and risk of multiple myeloma among US women. Occup Environ Med. 2009 Jan. 66 (1):68-70. [QxMD MEDLINE Link]. [Full Text].

13. Wadhera RK, Kyle RA, Larson DR, et al. Incidence, clinical course, and prognosis of secondary monoclonal gammopathy of undetermined significance in patients with multiple myeloma. Blood. 2011 Sep 15. 118(11):2985-7. [QxMD MEDLINE Link].

14. Yiin JH, Anderson JL, Daniels RD, Seel EA, Fleming DA, Waters KM, et al. A nested case-control study of multiple myeloma risk and uranium exposure among workers at the Oak Ridge Gaseous Diffusion Plant. Radiat Res. 2009 Jun. 171(6):637-45. [QxMD MEDLINE Link].

15. Caers J, Vande broek I, De Raeve H, Michaux L, Trullemans F, Schots R, et al. Multiple myeloma--an update on diagnosis and treatment. Eur J Haematol. 2008 Nov. 81(5):329-43. [QxMD MEDLINE Link].

16. Kyle RA, Rajkumar SV. Criteria for diagnosis, staging, risk stratification and response assessment of multiple myeloma. Leukemia. 2009 Jan. 23(1):3-9. [QxMD MEDLINE Link]. [Full Text].

17. Key Statistics About Multiple Myeloma. American Cancer Society. Available at https://www.cancer.org/cancer/multiple-myeloma/about/key-statistics.html. January 12, 2023; Accessed: January 13, 2023.

18. Surveillance, Epidemiology, and End Results Program. SEER Stat Fact Sheets: Myeloma. National Cancer Institute. Available at http://seer.cancer.gov/statfacts/html/mulmy.html. Accessed: January 13, 2023.

19. Ailawadhi S, Aldoss IT, Yang D, Razavi P, Cozen W, Sher T, et al. Outcome disparities in multiple myeloma: a SEER-based comparative analysis of ethnic subgroups. Br J Haematol. 2012 Apr 26. [QxMD MEDLINE Link].

20. Ludwig H, Durie BG, Bolejack V, Turesson I, Kyle RA, Blade J, et al. Myeloma in patients younger than age 50 years presents with more favorable features and shows better survival: an analysis of 10 549 patients from the International Myeloma Working Group. Blood. 2008 Apr 15. 111(8):4039-47. [QxMD MEDLINE Link].

21. Bataille R, Boccadoro M, Klein B, Durie B, Pileri A. C-reactive protein and beta-2 microglobulin produce a simple and powerful myeloma staging system. Blood. 1992 Aug 1. 80(3):733-7. [QxMD MEDLINE Link].

22. Augustson BM, Begum G, Dunn JA, Barth NJ, Davies F, Morgan G, et al. Early mortality after diagnosis of multiple myeloma: analysis of patients entered onto the United kingdom Medical Research Council trials between 1980 and 2002--Medical Research Council Adult Leukaemia Working Party. J Clin Oncol. 2005 Dec 20. 23(36):9219-26. [QxMD MEDLINE Link].

23. Blimark C, Holmberg E, Mellqvist UH, Landgren O, Björkholm M, Hultcrantz M, et al. Multiple myeloma and infections: a population-based study on 9253 multiple myeloma patients. Haematologica. 2015 Jan. 100(1):107-13. [QxMD MEDLINE Link]. [Full Text].

24. Bladé J, Fernández-Llama P, Bosch F, Montolíu J, Lens XM, Montoto S, et al. Renal failure in multiple myeloma: presenting features and predictors of outcome in 94 patients from a single institution. Arch Intern Med. 1998 Sep 28. 158(17):1889-93. [QxMD MEDLINE Link].

25. Dimopoulos M, Terpos E, Comenzo RL, Tosi P, Beksac M, Sezer O, et al. International myeloma working group consensus statement and guidelines regarding the current role of imaging techniques in the diagnosis and monitoring of multiple Myeloma. Leukemia. 2009 Sep. 23(9):1545-56. [QxMD MEDLINE Link].

26. Hung GU, Tsai CC, Tsai SC, Lin WY. Comparison of Tc-99m sestamibi and F-18 FDG-PET in the assessment of multiple myeloma. Anticancer Res. 2005 Nov-Dec. 25(6C):4737-41. [QxMD MEDLINE Link].

27. Shortt CP, Gleeson TG, Breen KA, McHugh J, O'Connell MJ, O'Gorman PJ, et al. Whole-Body MRI versus PET in assessment of multiple myeloma disease activity. AJR Am J Roentgenol. 2009 Apr. 192(4):980-6. [QxMD MEDLINE Link].

28. Zamagni E, Patriarca F, Nanni C, et al. Prognostic relevance of 18-F FDG PET/CT in newly diagnosed multiple myeloma patients treated with up-front autologous transplantation. Blood. 2011 Dec 1. 118(23):5989-95. [QxMD MEDLINE Link].

29. Durie BG, Salmon SE. A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival. Cancer. 1975 Sep. 36(3):842-54. [QxMD MEDLINE Link].

30. Greipp PR, San Miguel J, Durie BG, Crowley JJ, Barlogie B, Bladé J, et al. International staging system for multiple myeloma. J Clin Oncol. 2005 May 20. 23(15):3412-20. [QxMD MEDLINE Link].

31. Palumbo A, Avet-Loiseau H, Oliva S, et al. Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group. J Clin Oncol. 2015 Sep 10. 33 (26):2863-9. [QxMD MEDLINE Link]. [Full Text].

32. Dimopoulos MA, Moulopoulos A, Smith T, Delasalle KB, Alexanian R. Risk of disease progression in asymptomatic multiple myeloma. Am J Med. 1993 Jan. 94(1):57-61. [QxMD MEDLINE Link].

33. He Y, Wheatley K, Clark O, Glasmacher A, Ross H, Djulbegovic B. Early versus deferred treatment for early stage multiple myeloma. Cochrane Database Syst Rev. 2003. CD004023. [QxMD MEDLINE Link].

34. Munshi NC, Anderson KC, Bergsagel PL, et al. Consensus recommendations for risk stratification in multiple myeloma: report of the International Myeloma Workshop Consensus Panel 2. Blood. 2011 May 5. 117(18):4696-700. [QxMD MEDLINE Link].

35. Klein U, Jauch A, Hielscher T, et al. Chromosomal aberrations +1q21 and del(17p13) predict survival in patients with recurrent multiple myeloma treated with lenalidomide and dexamethasone. Cancer. 2011 May 15. 117(10):2136-44. [QxMD MEDLINE Link].

36. Neben K, Lokhorst HM, Jauch A, et al. Administration of bortezomib before and after autologous stem cell transplantation improves outcome in multiple myeloma patients with deletion 17p. Blood. 2012 Jan 26. 119(4):940-8. [QxMD MEDLINE Link].

37. Mateos MV, Hernández MT, Giraldo P, et al. Lenalidomide plus dexamethasone for high-risk smoldering multiple myeloma. N Engl J Med. 2013 Aug 1. 369(5):438-47. [QxMD MEDLINE Link].

38. Drug Shows Promise in Slowing Progression of Smoldering Myeloma to Cancer. National Cancer Institute. Available at https://www.cancer.gov/news-events/cancer-currents-blog/2019/lenalidomide-slows-progression-smoldering-myeloma. June 7, 2019; Accessed: March 5, 2020.

39. Zonder JA, Crowley J, Hussein MA, Bolejack V, Moore DF Sr, Whittenberger BF, et al. Lenalidomide and high-dose dexamethasone compared with dexamethasone as initial therapy for multiple myeloma: a randomized Southwest Oncology Group trial (S0232). Blood. 2010 Dec 23. 116(26):5838-41. [QxMD MEDLINE Link]. [Full Text].

40. Nelson R. High-risk smoldering myeloma benefits from early treatment. Medscape Medical News. August 1, 2013. [Full Text].

41. Mateos MV, Hernandez MT, Giraldo P, et al. Lenalidomide plus dexamethasone for high-risk smoldering multiple myeloma. N Engl J Med. 2013 Aug 1. 369(5):438-47. [QxMD MEDLINE Link].

42. Morgan GJ, Child JA, Gregory WM, et al. Effects of zoledronic acid versus clodronic acid on skeletal morbidity in patients with newly diagnosed multiple myeloma (MRC Myeloma IX): secondary outcomes from a randomised controlled trial. Lancet Oncol. 2011 Aug. 12(8):743-52. [QxMD MEDLINE Link].

43. Berenson JR, Lichtenstein A, Porter L, Dimopoulos MA, Bordoni R, George S, et al. Efficacy of pamidronate in reducing skeletal events in patients with advanced multiple myeloma. Myeloma Aredia Study Group. N Engl J Med. 1996 Feb 22. 334(8):488-93. [QxMD MEDLINE Link].

44. [Guideline] Anderson K, Ismaila N, Kyle RA. Role of Bone-Modifying Agents in Multiple Myeloma: American Society of Clinical Oncology Clinical Practice Guideline Update Summary. J Oncol Pract. 2018 Apr. 14 (4):266-269. [QxMD MEDLINE Link]. [Full Text].

45. Mikkilineni L, Kochenderfer JN. CAR T cell therapies for patients with multiple myeloma. Nat Rev Clin Oncol. 2021 Feb. 18 (2):71-84. [QxMD MEDLINE Link].

46. Dhakal B, Hari PN, Usmani SZ, Hamadani M. Chimeric antigen receptor T cell therapy in multiple myeloma: promise and challenges. Bone Marrow Transplant. 2021 Jan. 56 (1):9-19. [QxMD MEDLINE Link].

47. [Guideline] Terpos E, et al; Bone Working Group of the International Myeloma Working Group. Treatment of multiple myeloma-related bone disease: recommendations from the Bone Working Group of the International Myeloma Working Group. Lancet Oncol. 2021 Feb 2. [QxMD MEDLINE Link]. [Full Text].

48. Zonder JA, Crowley J, Hussein MA, et al. Superiority of lenalidomide (Len) plus high-dose dexamethasone (HD) compared to HD alone as treatment of newly-diagnosed multiple myeloma (NDMM): results of the randomized, double-blinded, placebo-controlled SWOG trial S0232 [abstract 77]. Blood. 2007. 110:32a. [Full Text].

49. Lokhorst HM, Sonneveld P, Cornelissen JJ, Joosten P, van Marwijk Kooy M, Meinema J, et al. Induction therapy with vincristine, adriamycin, dexamethasone (VAD) and intermediate-dose melphalan (IDM) followed by autologous or allogeneic stem cell transplantation in newly diagnosed multiple myeloma. Bone Marrow Transplant. 1999 Feb. 23(4):317-22. [QxMD MEDLINE Link].

50. Zervas K, Mihou D, Katodritou E, Pouli A, Mitsouli CH, Anagnostopoulos A, et al. VAD-doxil versus VAD-doxil plus thalidomide as initial treatment for multiple myeloma: results of a multicenter randomized trial of the Greek Myeloma Study Group. Ann Oncol. 2007 Aug. 18(8):1369-75. [QxMD MEDLINE Link].

51. Lenalidomide Improves Survival in Newly-Diagnosed Multiple Myeloma. Medscape Medical News. Available at http://www.medscape.com/viewarticle/807706. Accessed: July 23, 2013.

52. Rajkumar SV, Jacobus S, Callander NS, Fonseca R, Vesole DH, Williams ME, et al. Lenalidomide plus high-dose dexamethasone versus lenalidomide plus low-dose dexamethasone as initial therapy for newly diagnosed multiple myeloma: an open-label randomised controlled trial. Lancet Oncol. 2010 Jan. 11(1):29-37. [QxMD MEDLINE Link].

53. Niesvizky R, Jayabalan DS, Christos PJ, Furst JR, Naib T, Ely S, et al. BiRD (Biaxin [clarithromycin]/Revlimid [lenalidomide]/dexamethasone) combination therapy results in high complete- and overall-response rates in treatment-naive symptomatic multiple myeloma. Blood. 2008 Feb 1. 111(3):1101-9. [QxMD MEDLINE Link].

54. Richardson PG, Barlogie B, Berenson J, Singhal S, Jagannath S, Irwin D, et al. A phase 2 study of bortezomib in relapsed, refractory myeloma. N Engl J Med. 2003 Jun 26. 348(26):2609-17. [QxMD MEDLINE Link].

55. Harousseau JL, Mathiot C, Attal M, et al. VELCADE/dexamethasone (Vel/D) versus VAD as induction treatment prior to autologous stem cell transplantation (ASCT) in newly diagnosed multiple myeloma (MM): updated results of the IFM 2005/01 trial [abstract 450]. Blood. 2007. 110:139a. [Full Text].

56. Cavo M, Patriarca F, Tacchetti P, et al. . Bortezomib (Velcade[R])-thalidomide-dexamethasone (VTD) vs thalidomide-dexamethasone (TD) in preparation for autologous stem-cell (SC) transplantation (ASCT) in newly diagnosed multiple myeloma (MM) [abstract 73]. Blood. 2007. 110:30a. [Full Text].

57. Sher T, Ailawadhi S, Miller KC, et al. A steroid-independent regimen of bortezomib, liposomal doxorubicin and thalidomide demonstrate high response rates in newly diagnosed multiple myeloma patients. Br J Haematol. 2011 Jul. 154(1):104-10. [QxMD MEDLINE Link].

58. Harousseau JL, Palumbo A, Richardson PG, Schlag R, Dimopoulos MA, Shpilberg O, et al. Superior outcomes associated with complete response in newly diagnosed multiple myeloma patients treated with nonintensive therapy: analysis of the phase 3 VISTA study of bortezomib plus melphalan-prednisone versus melphalan-prednisone. Blood. 2010 Nov 11. 116(19):3743-50. [QxMD MEDLINE Link].

59. Moreau P, Pylypenko H, Grosicki S, et al. Subcutaneous versus intravenous administration of bortezomib in patients with relapsed multiple myeloma: a randomised, phase 3, non-inferiority study. Lancet Oncol. 2011 May. 12(5):431-40. [QxMD MEDLINE Link].

60. Mateos MV, Gutierrez NC, Martin-Ramos ML, et al. Outcome according to cytogenetic abnormalities and DNA ploidy in myeloma patients receiving short induction with weekly bortezomib followed by maintenance. Blood. 2011 Oct 27. 118(17):4547-53. [QxMD MEDLINE Link].

61. Moreau, Philippe, et al. Bortezomib, thalidomide, and dexamethasone with or without daratumumab before and after autologous stem-cell transplantation for newly diagnosed multiple myeloma (CASSIOPEIA): a randomised, open-label, phase 3 study. Lancet. 2019 Jul 6. 394 (10192):29-38. [QxMD MEDLINE Link].

62. Sonneveld P, Chanan-Khan A, Weisel K, Nooka AK, Masszi T, Beksac M, et al. Overall Survival With Daratumumab, Bortezomib, and Dexamethasone in Previously Treated Multiple Myeloma (CASTOR): A Randomized, Open-Label, Phase III Trial. J Clin Oncol. 2022 Nov 22. JCO2102734. [QxMD MEDLINE Link].

63. Dimopoulos MA, Oriol A, Nahi H, San-Miguel J, Bahlis NJ, Usmani SZ, et al. Overall Survival With Daratumumab, Lenalidomide, and Dexamethasone in Previously Treated Multiple Myeloma (POLLUX): A Randomized, Open-Label, Phase III Trial. J Clin Oncol. 2023 Jan 4. JCO2200940. [QxMD MEDLINE Link]. [Full Text].

64. Jagannath S, Richardson PG, Sonneveld P, Schuster MW, Irwin D, Stadtmauer EA, et al. Bortezomib appears to overcome the poor prognosis conferred by chromosome 13 deletion in phase 2 and 3 trials. Leukemia. 2007 Jan. 21(1):151-7. [QxMD MEDLINE Link].

65. Sagaster V, Ludwig H, Kaufmann H, Odelga V, Zojer N, Ackermann J, et al. Bortezomib in relapsed multiple myeloma: response rates and duration of response are independent of a chromosome 13q-deletion. Leukemia. 2007 Jan. 21(1):164-8. [QxMD MEDLINE Link].

66. Myeloma Trialists' Collaborative Group. Combination chemotherapy versus melphalan plus prednisone as treatment for multiple myeloma: an overview of 6,633 patients from 27 randomized trials. J Clin Oncol. 1998 Dec. 16(12):3832-42. [QxMD MEDLINE Link].

67. Facon T, Mary JY, Hulin C, Benboubker L, Attal M, Pegourie B, et al. Melphalan and prednisone plus thalidomide versus melphalan and prednisone alone or reduced-intensity autologous stem cell transplantation in elderly patients with multiple myeloma (IFM 99-06): a randomised trial. Lancet. 2007 Oct 6. 370(9594):1209-18. [QxMD MEDLINE Link].

68. Hulin C, Facon T, Rodon P, Pegourie B, Benboubker L, Doyen C, et al. Efficacy of melphalan and prednisone plus thalidomide in patients older than 75 years with newly diagnosed multiple myeloma: IFM 01/01 trial. J Clin Oncol. 2009 Aug 1. 27(22):3664-70. [QxMD MEDLINE Link].

69. Waage A, Gimsing P, Fayers P, Abildgaard N, Ahlberg L, Björkstrand B, et al. Melphalan and prednisone plus thalidomide or placebo in elderly patients with multiple myeloma. Blood. 2010 Sep 2. 116(9):1405-12. [QxMD MEDLINE Link].

70. Fayers PM, Palumbo A, Hulin C, et al. Thalidomide for previously untreated elderly patients with multiple myeloma: meta-analysis of 1685 individual patient data from 6 randomized clinical trials. Blood. 2011 Aug 4. 118(5):1239-47. [QxMD MEDLINE Link].

71. Zweegman S, van der Holt B, Mellqvist UH, et al. Melphalan, prednisone, and lenalidomide versus melphalan, prednisone, and thalidomide in untreated multiple myeloma. Blood. 2016 Mar 3. 127 (9):1109-16. [QxMD MEDLINE Link]. [Full Text].

72. Gay F, Larocca A, Wijermans P, et al. Complete response correlates with long-term progression-free and overall survival in elderly myeloma treated with novel agents: analysis of 1175 patients. Blood. 2011 Mar 17. 117(11):3025-31. [QxMD MEDLINE Link].

73. Mateos MV, et al, for the ALCYONE Trial Investigators. Daratumumab plus Bortezomib, Melphalan, and Prednisone for Untreated Myeloma. N Engl J Med. 2017 Dec 12. [QxMD MEDLINE Link]. [Full Text].

74. Facon T, et al. Daratumumab plus Lenalidomide and Dexamethasone for Untreated Myeloma. N Engl J Med. 2019 May 30. 380 (22):2104-2115. [QxMD MEDLINE Link]. [Full Text].

75. Spencer A, Prince HM, Roberts AW, et al. Consolidation therapy with low-dose thalidomide and prednisolone prolongs the survival of multiple myeloma patients undergoing a single autologous stem-cell transplantation procedure. J Clin Oncol. 2009 Apr 10. 27(11):1788-93. [QxMD MEDLINE Link].

76. Lokhorst HM, van der Holt B, Zweegman S, et al. A randomized phase 3 study on the effect of thalidomide combined with adriamycin, dexamethasone, and high-dose melphalan, followed by thalidomide maintenance in patients with multiple myeloma. Blood. 2010 Feb 11. 115(6):1113-20. [QxMD MEDLINE Link].

77. Morgan GJ, Gregory WM, Davies FE, et al. The role of maintenance thalidomide therapy in multiple myeloma: MRC Myeloma IX results and meta-analysis. Blood. 2012 Jan 5. 119(1):7-15. [QxMD MEDLINE Link].

78. McCarthy PL, Owzar K, Hofmeister CC, et al. Lenalidomide after stem-cell transplantation for multiple myeloma. N Engl J Med. 2012 May 10. 366(19):1770-81. [QxMD MEDLINE Link]. [Full Text].

79. Attal M, Lauwers-Cances V, Marit G, et al. Lenalidomide maintenance after stem-cell transplantation for multiple myeloma. N Engl J Med. 2012 May 10. 366(19):1782-91. [QxMD MEDLINE Link].

80. Yang B, Yu RL, Chi XH, Lu XC. Lenalidomide treatment for multiple myeloma: systematic review and meta-analysis of randomized controlled trials. PLoS One. 2013. 8 (5):e64354. [QxMD MEDLINE Link]. [Full Text].

81. Sonneveld P, Schmidt-Wolf IG, van der Holt B, et al. Bortezomib induction and maintenance treatment in patients with newly diagnosed multiple myeloma: results of the randomized phase III HOVON-65/ GMMG-HD4 trial. J Clin Oncol. 2012 Aug 20. 30(24):2946-55. [QxMD MEDLINE Link].

82. Palumbo A, Hajek R, Delforge M, et al. Continuous lenalidomide treatment for newly diagnosed multiple myeloma. N Engl J Med. 2012 May 10. 366(19):1759-69. [QxMD MEDLINE Link].

83. Palumbo A, Mina R. Part II: role of maintenance therapy in transplant-ineligible patients. J Natl Compr Canc Netw. 2013 Jan 1. 11(1):43-9. [QxMD MEDLINE Link].

84. FDA approves carfilzomib and daratumumab with dexamethasone for multiple myeloma. U.S. Food & Drug Administration. Available at https://www.fda.gov/drugs/drug-approvals-and-databases/fda-approves-carfilzomib-and-daratumumab-dexamethasone-multiple-myeloma. August 21, 2020; Accessed: September 2, 2020.

85. San-Miguel JF, Hungria VT, Yoon SS, Beksac M, Dimopoulos MA, Elghandour A, et al. Panobinostat plus bortezomib and dexamethasone versus placebo plus bortezomib and dexamethasone in patients with relapsed or relapsed and refractory multiple myeloma: a multicentre, randomised, double-blind phase 3 trial. Lancet Oncol. 2014 Oct. 15(11):1195-206. [QxMD MEDLINE Link].

86. Kyprolis (carfilzomib) [package insert]. South San Francisco, CA: Onyx Pharmaceuticals. July 2012. Available at [Full Text].

87. Stewart AK, Rajkumar SV, Dimopoulos MA, Masszi T, Špička I, Oriol A, et al. Carfilzomib, lenalidomide, and dexamethasone for relapsed multiple myeloma. N Engl J Med. 2015 Jan 8. 372 (2):142-52. [QxMD MEDLINE Link]. [Full Text].

88. Dimopoulos MA, Moreau P, Palumbo A, Joshua D, Pour L, Hájek R, et al. Carfilzomib and dexamethasone versus bortezomib and dexamethasone for patients with relapsed or refractory multiple myeloma (ENDEAVOR): a randomised, phase 3, open-label, multicentre study. Lancet Oncol. 2016 Jan. 17 (1):27-38. [QxMD MEDLINE Link].

89. Dimopoulos MA, Goldschmidt H, Niesvizky R, Joshua D, Chng WJ, Oriol A, et al. Carfilzomib or bortezomib in relapsed or refractory multiple myeloma (ENDEAVOR): an interim overall survival analysis of an open-label, randomised, phase 3 trial. Lancet Oncol. 2017 Oct. 18 (10):1327-1337. [QxMD MEDLINE Link].

90. Lonial S, Weiss BM, Usmani SZ, Singhal S, Chari A, et al. Daratumumab monotherapy in patients with treatment-refractory multiple myeloma (SIRIUS): an open-label, randomised, phase 2 trial. Lancet. 2016 Apr 9. 387 (10027):1551-60. [QxMD MEDLINE Link]. [Full Text].

91. Lokhorst HM, Plesner T, Laubach JP, Nahi H, Gimsing P, Hansson M, et al. Targeting CD38 with Daratumumab Monotherapy in Multiple Myeloma. N Engl J Med. 2015 Sep 24. 373 (13):1207-19. [QxMD MEDLINE Link].

92. Moreau P, et al, for the TOURMALINE-MM1 Study Group. Oral Ixazomib, Lenalidomide, and Dexamethasone for Multiple Myeloma. N Engl J Med. 2016 Apr 28. 374 (17):1621-34. [QxMD MEDLINE Link]. [Full Text].

93. Lonial S, Dimopoulos M, Palumbo A, White D, Grosicki S, Spicka I, et al. Elotuzumab Therapy for Relapsed or Refractory Multiple Myeloma. N Engl J Med. 2015 Aug 13. 373 (7):621-31. [QxMD MEDLINE Link].

94. Dimopoulos MA, Dytfeld D, Grosicki S, Moreau P, Takezako N, Hori M, et al. Elotuzumab plus Pomalidomide and Dexamethasone for Multiple Myeloma. N Engl J Med. 2018 Nov 8. 379 (19):1811-1822. [QxMD MEDLINE Link].

95. Attal M, Richardson PG, Rajkumar SV, San-Miguel J, Beksac M, Spicka I, et al. Isatuximab plus pomalidomide and low-dose dexamethasone versus pomalidomide and low-dose dexamethasone in patients with relapsed and refractory multiple myeloma (ICARIA-MM): a randomised, multicentre, open-label, phase 3 study. Lancet. 2019 Dec 7. 394 (10214):2096-2107. [QxMD MEDLINE Link].

96. FDA approves isatuximab-irfc for multiple myeloma. U.S. Food & Drug Administration. Available at https://www.fda.gov/drugs/drug-approvals-and-databases/fda-approves-isatuximab-irfc-multiple-myeloma. March 31, 2021; Accessed: April 15, 2021.

97. Kumar S, Witzig TE, Rajkumar SV. Thalidomid: current role in the treatment of non-plasma cell malignancies. J Clin Oncol. 2004 Jun 15. 22(12):2477-88. [QxMD MEDLINE Link].

98. Weber DM, Chen C, Niesvizky R, Wang M, Belch A, Stadtmauer EA, et al. Lenalidomide plus dexamethasone for relapsed multiple myeloma in North America. N Engl J Med. 2007 Nov 22. 357(21):2133-42. [QxMD MEDLINE Link].

99. Lacy MQ, Allred JB, Gertz MA, et al. Pomalidomide plus low-dose dexamethasone in myeloma refractory to both bortezomib and lenalidomide: comparison of 2 dosing strategies in dual-refractory disease. Blood. 2011 Sep 15. 118(11):2970-5. [QxMD MEDLINE Link].

100. Leleu X, Attal M, Arnulf B, Moreau P, Traulle C, Marit G, et al. Pomalidomide plus low dose dexamethasone is active and well tolerated in bortezomib and lenalidomide refractory multiple myeloma: IFM 2009-02. Blood. 2013 Jan 14. [QxMD MEDLINE Link].

101. Chustecka Z, Mulcahy N. FDA Approves Pomalidomide for Multiple Myeloma. Medscape Medical News. Available at http://www.medscape.com/viewarticle/779048. February 8, 2013; Accessed: January 11, 2018.

102. Miguel JS, Weisel K, Moreau P, Lacy M, Song K, Delforge M, et al. Pomalidomide plus low-dose dexamethasone versus high-dose dexamethasone alone for patients with relapsed and refractory multiple myeloma (MM-003): a randomised, open-label, phase 3 trial. Lancet Oncol. 2013 Sep 2. [QxMD MEDLINE Link].

103. Ajai C, Vogl DT, et al. Results of the Pivotal STORM Study (Part 2) in Penta-Refractory Multiple Myeloma (MM): Deep and Durable Responses with Oral Selinexor Plus Low Dose Dexamethasone in Patients with Penta-Refractory MM. Blood 2018 132:598. [Full Text].

104. Xpovio (selinexor) [package insert]. Newton, MA: Karyopharm Therapeutics, Inc. July 2019. Available at [Full Text].

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Dhaval Shah, MD Helen F Graham Cancer Center and Research Institute

Dhaval Shah, MD is a member of the following medical societies: American Society of Clinical Oncology, American Society of Hematology

Disclosure: Nothing to disclose.

Karen Seiter, MD Professor, Department of Internal Medicine, Division of Oncology/Hematology, New York Medical College

Karen Seiter, MD is a member of the following medical societies: American Association for Cancer Research, American College of Physicians, American Society of Hematology

Disclosure: Received honoraria from Novartis for speaking and teaching; Received consulting fee from Novartis for speaking and teaching; Received honoraria from Celgene for speaking and teaching.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Emmanuel C Besa, MD Professor Emeritus, Department of Medicine, Division of Hematologic Malignancies and Hematopoietic Stem Cell Transplantation, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University

Emmanuel C Besa, MD is a member of the following medical societies: American Association for Cancer Education, American Society of Clinical Oncology, American College of Clinical Pharmacology, American Federation for Medical Research, American Society of Hematology, New York Academy of Sciences

Disclosure: Nothing to disclose.

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