Society of Hematologic Oncology State of the Art Update and Next Questions: Multiple Myeloma

During the past decade, the survival outcomes of patients with multiple myeloma (MM) have dramatically improved, not only owing to the advent of a number of novel therapies, but also to the deepening insight regarding how to best use these options. Triplet-based induction regimens can yield overall response rates of <= 100%. In the relapsed and refractory setting, we have a multitude of doublet and triplet options available with high and durable response rates. The addition of monoclonal antibodies has provided a new class of agents to augment our standard approach with novel therapies. Minimal residual disease status testing has worked its way into the lexicon of the myeloma-treating physician and provides both prognostic and potentially therapeutic insight into management. Despite the influx of novel therapies, high-dose melphalan with autologous stem cell rescue remains a vital tenet of induction therapy for our younger and more fit patients. The current generation of clinical trials using immunologic approaches such as bifunctional antibodies and chimeric antigen receptor T cells is extremely promising and will likely become the future standard of care. Although the disease remains, on the whole, incurable, we now possess therapeutic modalities that can provide deep and durable remissions and, potentially, cure for some. (C) 2018 Elsevier Inc. All rights reserved.