Advances in the treatment of extramedullary disease in multiple myeloma

Li, Yating; Sun, Zhengxu; Qu, Xiaoyan

doi:10.1016/j.tranon.2022.101465

Cited by 15 publications

(11 citation statements)

References 89 publications

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“…Chemotherapy for plasmacytoma is similar to that for MM, with a combination of alkylating agents, proteasome inhibitors, immunomodulatory drugs, and CD38 monoclonal antibodies. 8,9 In the present case, the plasmacytoma was confined to the liver; however, the BLd regimen was selected because of the presence of multiple tumors and negative CD38 expression. Plasma cells are typically strongly positive for CD38, which has been exploited as a therapeutic target for anti-CD38 mAbs.…”

Section: Discussionmentioning

confidence: 97%

“…1 Although liver involvement is known in the relapsed and late stages of multiple myeloma (MM), solitary plasmacytoma confined to the liver is rare, with only 19 cases of solitary plasmacytoma of the liver reported since 1990, all at the time of initial presentation. [4][5][6][7][8][9] Here, we report the first case of refractory plasmacytoma confined to the liver that relapsed 10 years after its onset.…”

Section: Introductionmentioning

confidence: 86%

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Recurrence of solitary plasmacytoma in the liver 10 years after the onset of multiple bone lesions

Numata,

Tsunemine,

Imai

et al. 2024

J Clin Exp Hematopathol

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A 79-year-old man presented with a history of solitary plasmacytoma in the bone 10 years ago. Chemoradiotherapy was effective, and remission was maintained with intermittent treatment at relapse of the bone lesions. One year after the last treatment, a follow-up computed tomography (CT) scan revealed multiple liver masses, and a liver biopsy revealed plasmacytoma. There was no clonal plasma cell infiltration in the bone marrow, and the final diagnosis was solitary plasmacytomas of the liver. Although liver involvement is known in relapsed refractory multiple myeloma, solitary plasmacytoma in the relapsed stage confined to the liver is rare, and all previous reports have been from the initial presentation. To the best of our knowledge, this is the first recurrent case of solitary plasmacytoma of the liver.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 86%

Recurrence of solitary plasmacytoma in the liver 10 years after the onset of multiple bone lesions

Numata,

Tsunemine,

Imai

et al. 2024

J Clin Exp Hematopathol

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“…Immunomodulatory agents enhance the immune response against cancer cells. Monoclonal antibodies can selectively target plasma cells, leading to their destruction [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Plasmacytoma in the Maxillary Jaw: A Diagnostic and Therapeutic Challenge

Bernardi,

Bianchi,

Lupi

et al. 2024

Hematology Reports

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Plasmacytoma is a neoplastic disorder originating from plasma cells, with bone and soft tissue being common sites of manifestation. This report presents the clinical and radiological findings of a 65-year-old female patient who presented with an exophytic lesion in the upper right lateral incisor region. The lesion appeared as a unilocular radiotransparent area in imaging tests. Following an excisional biopsy, histological and immunohistochemical evaluations confirmed the presence of mature plasmacellular elements and small infiltrates of B and T lymphocytes. The patient did not exhibit systemic manifestations of multiple myeloma. Surgical intervention, in the form of enucleation of the lesion combined with root canal treatment and apicoectomy, was performed. This case underscores the rare occurrence of plasmacytoma in the jaw region and highlights the importance of surgical management in cases where structural damage or functional impairment is present. Further research on novel treatment approaches is also mentioned, including targeted therapies, immunomodulatory agents, and monoclonal antibodies. The patient is currently under the care of a hematologist for further investigation and the choice of the most appropriate therapy.

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“…However, in both studies, Bor was administered i.v., whereas the therapeutic potential of intracavitary-administered Bor has not yet been investigated in patients with MM to our knowledge. Nonetheless, clinical results obtained in patients with recurrent ovarian cancer and myelomatous pleural effusions indicate that the intrapleural/intraperitoneal administration of Bor is feasible and has promising antitumor activity [77][78][79]. In fact, that the anticancer properties of Bor are currently underexploited for the treatment of solid tumors is evidenced by the many efforts which have recently been devoted to the development of Bor-based drug delivery systems that may improve its accumulation at the targeted tumor site [80].…”

Section: Discussionmentioning

confidence: 99%

Antitumoral effects of Bortezomib in malignant mesothelioma: evidence of mild endoplasmic reticulum stress in vitro and activation of T cell response in vivo

et al. 2023

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Background Malignant mesothelioma (MM) is a rare tumor with a dismal prognosis. The low efficacy of current treatment options highlights the urge to identify more effective therapies aimed at improving MM patients’ survival. Bortezomib (Bor) is a specific and reversible inhibitor of the chymotrypsin-like activity of the 20S core of the proteasome, currently approved for the treatment of multiple myeloma and mantle cell lymphoma. On the other hand, Bor appears to have limited clinical effects on solid tumors, because of its low penetration and accumulation into tumor tissues following intravenous administration. These limitations could be overcome in MM through intracavitary delivery, with the advantage of increasing local drug concentration and decreasing systemic toxicity. Methods In this study, we investigated the effects of Bor on cell survival, cell cycle distribution and modulation of apoptotic and pro-survival pathways in human MM cell lines of different histotypes cultured in vitro. Further, using a mouse MM cell line that reproducibly forms ascites when intraperitoneally injected in syngeneic C57BL/6 mice, we investigated the effects of intraperitoneal Bor administration in vivo on both tumor growth and the modulation of the tumor immune microenvironment. Results We demonstrate that Bor inhibited MM cell growth and induced apoptosis. Further, Bor activated the Unfolded Protein Response, which however appeared to participate in lowering cells’ sensitivity to the drug’s cytotoxic effects. Bor also affected the expression of EGFR and ErbB2 and the activation of downstream pro-survival signaling effectors, including ERK1/2 and AKT. In vivo, Bor was able to suppress MM growth and extend mice survival. The Bor-mediated delay of tumor progression was sustained by increased activation of T lymphocytes recruited to the tumor microenvironment. Conclusions The results presented herein support the use of Bor in MM and advocate future studies aimed at defining the therapeutic potential of Bor and Bor-based combination regimens for this treatment-resistant, aggressive tumor.

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Advances in the treatment of extramedullary disease in multiple myeloma

Cited by 15 publications

References 89 publications

Recurrence of solitary plasmacytoma in the liver 10 years after the onset of multiple bone lesions

Recurrence of solitary plasmacytoma in the liver 10 years after the onset of multiple bone lesions

Plasmacytoma in the Maxillary Jaw: A Diagnostic and Therapeutic Challenge

Antitumoral effects of Bortezomib in malignant mesothelioma: evidence of mild endoplasmic reticulum stress in vitro and activation of T cell response in vivo

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