Prevention and management of adverse events of Novel agents in multiple myeloma: A consensus of the european myeloma network

Abstract

During the last few years, several new drugs have been introduced for treatment of patients with multiple myeloma, which have significantly improved treatment outcome. All of these novel substances differ at least in part in their mode of action from similar drugs of the same drug class, or are representatives of new drugs classes, and as such present with very specific side effect profiles. In this review, we summarize these adverse events, provide information on their prevention, and give practical guidance for monitoring of patients and for management of adverse events.

Developments in continuous therapy and maintenance treatment approaches for patients with newly diagnosed multiple myeloma

“…The findings from phase 3 studies reviewed herein have highlighted the differential feasibility of some agents as long-term therapy, due to tolerability limiting treatment durations and increasing rates of discontinuation due to AEs (Table 3); indeed, for some agents/regimens, based on the benefit/risk balance, a fixed-duration approach may be more appropriate for some patients. Long-term therapy with both thalidomide 27,29,52,53,73 and bortezomib 52,53,69,70 has been associated with a substantially increased risk of peripheral neuropathy, which can be dose-limiting, while continuous and maintenance lenalidomide therapies have resulted in increased rates of hematologic toxicity, notably grade 3/4 neutropenia 25,40,73 , as well as chronic diarrhea 91 . Lenalidomide has also been associated with an increased risk of SPMs; in the meta-analysis of phase 3 studies of lenalidomide maintenance post ASCT, the cumulative rates of hematologic and solid SPMs prior to disease progression on lenalidomide maintenance were 5.3% and 5.8%, vs. 0.8% and 2.0% with placebo/observation 32 .…”

Prevention, monitoring and treatment of cardiovascular adverse events in myeloma patients receiving carfilzomib A consensus paper by the European Myeloma Network and the Italian Society of Arterial Hypertension

“…Although the causes are not clear, it could be a symptom related to cardiovascular conditions, such as cardiac failure, as well as pulmonary complications. Venous thromboembolic events and thrombotic microangiopathy have also been reported in patients who received CFZ .…”

COVID-19 in persons with haematological cancers

“…There are few data on risk of developing COVID-19 in hospitalised persons with haematological cancers. Many, if not most persons with haematological cancers receive anticancer drugs with suppress bone marrow function or have cancers of the immune system and are at substantial risk of community-and hospital-acquired infections [19][20][21].…”