title: Management of relapsed and refractory multiple myeloma in modern times: Incorporating new agents into decision-making.
abstract: Although upfront treatment of multiple myeloma has become more effective, relapses are the norm, often driven by the emergence of a genetically divergent clone selected by the initial therapy. Recent trials have demonstrated the safety and efficacy of combination therapy also in the relapsed and refractory setting and supported the regulatory approval of several new agents including new proteasome inhibitors, immunomodulatory agents, and monoclonal antibodies. We provide a detailed summary of recent practice-changing trials in relapsed and refractory MM and share a practical approach to assimilate disease and patient-features into treatment decision. Am. J. Hematol. 91:1044-1051, 2016. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Clark
authors.affiliation: Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Cornell
authors.affiliation: Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon.
authors.forename: Emma C
authors.identifier: 0000-0002-1548-551X
authors.initials: EC
authors.lastname: Scott
authors.affiliation: Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Jae
authors.initials: J
authors.lastname: Chung
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama. ljcosta@uabmc.edu.
authors.forename: Luciano J
authors.initials: LJ
authors.lastname: Costa
mesh_terms: D019468:Disease Management; D006801:Humans; D009101:Multiple Myeloma / Q000628:therapy*; D016879:Salvage Therapy / Q000379:methods* / Q000639:trends