title: Mechanisms of Drug Resistance in Relapse and Refractory Multiple Myeloma.
abstract: Multiple myeloma (MM) is a hematological malignancy that remains incurable because most patients eventually relapse or become refractory to current treatments. Although the treatments have improved, the major problem in MM is resistance to therapy. Clonal evolution of MM cells and bone marrow microenvironment changes contribute to drug resistance. Some mechanisms affect both MM cells and microenvironment, including the up- and downregulation of microRNAs and programmed death factor 1 (PD-1)/PD-L1 interaction. Here, we review the pathogenesis of MM cells and bone marrow microenvironment and highlight possible drug resistance mechanisms. We also review a potential molecular targeting treatment and immunotherapy for patients with refractory or relapse MM.
authors.affiliation: Division of Hematology and Medical Oncology, Department of Internal Medicine, Yuan's General Hospital, No. 162, Cheng Kung 1st Road, Kaohsiung 802, Taiwan ; Molecular Medicine Lab, Yuan's General Hospital, No. 162, Cheng Kung 1st Road, Kaohsiung 802, Taiwan ; Faculty of Meiho University, No. 23, Pingguang Road, Neipu, Pingtung 912, Taiwan.
authors.forename: Wen-Chi
authors.initials: WC
authors.lastname: Yang
authors.affiliation: Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung 807, Taiwan ; Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung 807, Taiwan.
authors.forename: Sheng-Fung
authors.initials: SF
authors.lastname: Lin
mesh_terms: D001854:Bone Marrow Cells / Q000187:drug effects / Q000473:pathology; D002448:Cell Adhesion / Q000187:drug effects; D019008:Drug Resistance, Neoplasm / Q000235:genetics*; D006801:Humans; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D012008:Recurrence; D059016:Tumor Microenvironment / Q000187:drug effects