Λίστα αντικειμένων
New guidelines for treatment of MM (EHA/ESMO)
Presenter S. Kastritis
Participation Spyridonidis, Liga, Tsokanas
Diagnostic obligatory are still Free light chain serum, 24-Urin, cytogenetics (Del17p, t(4,14), WBLD-CT and if negative Whole body MRI.
Asymptomatic MM (use 20/2/20 score), if high (2 of 3) risk score these pats should be included in trials and receive therapy
First line treatment VRd, or DaraVTD, alternative VTD, VCD. Others DaraRD, DaraVMP, VRd, VMP, RD. KRd does not provide benefit and is toxic
Autologous (HD Mel 200, 140 in renal insufficiency) is still indicated
Consolidation, in high risk pts 2nd ASCT or VRD, StaMIna study did not confirm
Maintenance standard of care, Lenalidomide, alternative, bortezomib/ ixazomib
1st Relapse. If response to rescue therapy Autologous HSCT may provide benefit (German study)
Lenalidomide refractory/relapse Dara, Kd, Selinexor, in t11,14 venetoclax
Dara refractory relapse drugs are investigated
References
Ann Oncol. 2021 Mar;32(3):309-322. doi: 10.1016/j.annonc.2020.11.014.
Hemasphere. 2021 Feb 3;5(2):e528