UPDATES ON MANAGEMENT OF REFRACTORY/ RELAPSED MULTIPLE MYELOMA AND ITS ASSOCIATED ANXIETY AND DEPRESSION: A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS

Abstract

Ibrahim Abdelkhalek Ibrahim*, Reef Faris Ismail Alsabilah, Raghad Faris Ismail Alsabilah, Haya Khaled Saud Altarif, Hadeel Abdulrahman Aljoufi, Shahad Fayez Hassan Albalawi and Shafi Ali Alsharari

Objectives: To study the recently published randomized control trials (RCTs) on the management of relapsed/ refractory multiple myeloma (RRMM).

Methods: We conducted a thorough search of PubMed, SCOPUS, Web of Science, and Google Scholar to find pertinent literature. Rayyan QRCI was utilized during the entire process.

Results: We included seven studies with a total of 1578 children and 953 (60.4%) were males. The follow-up duration ranged from 7.1 to 65.4 months. One study used mAb alone and reported that this line of treatment is fast, of high quality, and with a good safety profile. Another study used mAb (Daratumumab) along with an bortezomib and dexamethasone and reported that this combination showed significant efficacy advantages regarding PFS, OS, and depth of response. PFS, OS, and depth of response also were improved by using the combination of aponermin with thalidomide and Pomalidomide/ dexamethasone (EPd). Idecabtagene vicleucel (ide-cel) treatment dramatically extended PFS and enhanced response as compared to conventional regimens

Conclusion: Highly successful treatments for RRMM are assisting in the management of the condition in our patients, improving their chances of survival and preserving their quality of life. As we work to find a functional cure for myeloma patients, there is hope in sight. Novel treatments like ide-cel are demonstrating tremendous efficacy in even the most heavily treated patients, much beyond what was observed two decades ago. With myeloma becoming recognized more and more as a chronic illness, it will be critical to address issues with patient quality of life, reported outcomes, financial burdens, and unequal access to care in addition to survival and response when evaluating novel therapies.