{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:37:21Z","timestamp":1777934241907,"version":"3.51.4"},"reference-count":101,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2015,2,17]],"date-time":"2015-02-17T00:00:00Z","timestamp":1424131200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Oncol Pharm Pract"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:p>There have been a number of recent advances in the treatment of patients with relapsed and refractory multiple myeloma. However, despite additional FDA-approved therapies including carfilzomib and pomalidomide as well as clinical trials investigating new combinations of existing treatments, multiple myeloma remains an incurable disease. New therapies currently in the drug development pipeline for relapsed and refractory disease include additional proteasome inhibitors (oprozomib, marizomib, ixazomib), histone deacetylase inhibitors (panobinostat, ricolinostat, quisinostat), monoclonal antibodies (daratumumab, elotuzumab, SAR650984), Bruton\u2019s tyrosine kinase inhibitors (ibrutinib), a selective inhibitor of nuclear export, and others. This review will focus on these newly developing therapies as well as the ever expanding role of the pharmacist in supportive care for patients with relapsed and refractory multiple myeloma.<\/jats:p>","DOI":"10.1177\/1078155215572036","type":"journal-article","created":{"date-parts":[[2015,2,18]],"date-time":"2015-02-18T20:43:57Z","timestamp":1424292237000},"page":"289-302","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Multiple myeloma: Updates for pharmacists in the treatment of relapsed and refractory disease"],"prefix":"10.1177","volume":"22","author":[{"given":"Emily","family":"Ashjian","sequence":"first","affiliation":[{"name":"University of Michigan Health System, Department of Pharmacy Services, University of Michigan College of Pharmacy, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly","family":"Redic","sequence":"additional","affiliation":[{"name":"University of Michigan Health System, Department of Pharmacy Services, University of Michigan College of Pharmacy, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,2,17]]},"reference":[{"key":"bibr1-1078155215572036","volume-title":"Cancer facts & figures 2014","author":"American Cancer Society","year":"2014"},{"key":"bibr2-1078155215572036","unstructured":"Surveillance, Epidemiology, and End Results (SEER) Cancer Statistics Factsheets: Myeloma. 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Summit, NJ: Celgene, 2013."},{"key":"bibr10-1078155215572036","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-01-476267"},{"key":"bibr11-1078155215572036","unstructured":"Revlimid [package insert]. Summit, NJ: Celgene, 2013."},{"key":"bibr12-1078155215572036","doi-asserted-by":"crossref","unstructured":"Matous J, Siegel D, Duong HK, et\u00a0al. MM-008 trial: Pharmacokinetics (PK) and tolerability of pomalidomide plus low-dose dexamethasone (POM plus LoDEX) in relapsed\/refractory multiple myeloma (RRMM) patients with renal impairment.\n                      J Clin Oncol\n                      2013; suppl: abstr 8585.","DOI":"10.1200\/jco.2013.31.15_suppl.8585"},{"key":"bibr13-1078155215572036","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.23.6802"},{"key":"bibr14-1078155215572036","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2010.190"},{"key":"bibr15-1078155215572036","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(13)70380-2"},{"key":"bibr16-1078155215572036","unstructured":"Oncotherapeutics. A phase 1\/2 study of pomalidomide, dexamethasone, and pegylated liposomal doxorubicin for patients with relapsed\/refractory multiple myeloma. In: ClinicalTrials.gov [Internet]. 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South San Francisco, CA: Onyx Pharmaceuticals Inc.; 2013."},{"key":"bibr23-1078155215572036","doi-asserted-by":"crossref","unstructured":"Berenson JR, Klein L, Rifkin RM, et\u00a0al. A Phase 1, dose-escalation study (CHAMPION-1) investigating weekly carfilzomib in combination with dexamethasone for patients with relapsed or refractory multiple myeloma. 2013; ASH Annual Meeting Abstr 1934.","DOI":"10.1182\/blood.V122.21.1934.1934"},{"key":"bibr24-1078155215572036","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-05-425934"},{"key":"bibr25-1078155215572036","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1411321"},{"key":"bibr26-1078155215572036","unstructured":"Onyx Therapeutics, Inc. A study of carfilzomib plus best supportive care in subjects with relapsed and refractory multiple myeloma (FOCUS). In: ClinicalTrials.gov [Internet]. 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A phase II study with carfilzomib, cyclophosphamide and dexamethasone (CCd) for newly diagnosed multiple myeloma 2013; ASH Annual Meeting Abstr 685.","DOI":"10.1182\/blood.V122.21.685.685"},{"key":"bibr29-1078155215572036","doi-asserted-by":"crossref","unstructured":"Korde N, Zingone A, Kwok ML, et\u00a0al. Phase II clinical and correlative study of carfilzomib, lenalidomide, and dexamethasone followed by lenalidomide extended dosing (CRD-R) induces high rates of MRD negativity in newly diagnosed multiple myeloma (MM) patients 2013; ASH Annual Meeting Abstr 653.","DOI":"10.1182\/blood.V122.21.538.538"},{"key":"bibr30-1078155215572036","doi-asserted-by":"publisher","DOI":"10.1309\/74R4TB90BUWH27JX"},{"key":"bibr31-1078155215572036","doi-asserted-by":"publisher","DOI":"10.1016\/S0145-2126(00)00093-X"},{"key":"bibr32-1078155215572036","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-07-0402"},{"key":"bibr33-1078155215572036","doi-asserted-by":"publisher","DOI":"10.1038\/nm1101-1209"},{"key":"bibr34-1078155215572036","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1003032"},{"key":"bibr35-1078155215572036","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2010.030759"},{"key":"bibr36-1078155215572036","unstructured":"Genmab. 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National Library of Medicine (US), http:\/\/clinicaltrials.gov\/ct2\/show\/NCT01615029?term=NCT01615029 NLM Identifier: NCT01615029 (2000, accessed 26 Feb 2014)."},{"key":"bibr39-1078155215572036","unstructured":"Janssen Research and Development, LLC. An efficacy and safety study of daratumumab in patients with multiple myeloma who have received at least 3 prior lines of therapy (including a proteasome inhibitor (PI) and immunomodulatory drug [ImiD]) or are double refractory to a PI and an ImiD. In: ClinicalTrials.gov[Internet]. National Library of Medicine (US), http:\/\/clinicaltrials.gov\/ct2\/show\/NCT01985126?term=%28NCT01985126%29&rank=1. NLM Identifier: NCT01985126 (2000, accessed 16 March 2014)."},{"key":"bibr40-1078155215572036","unstructured":"Janssen Research and Development, LLC. A study comparing daratumumab, lenalidomide, and dexamethasone with lenalidomide and dexamethasone in relapsed or refractory multiple myeloma. In: ClinicalTrials.gov[Internet]. 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NLM Identifier: NCT01998971 (2000, accessed 16 March 2014)."},{"key":"bibr42-1078155215572036","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-07-4246"},{"key":"bibr43-1078155215572036","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-08-107292"},{"key":"bibr44-1078155215572036","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-06-360552"},{"key":"bibr45-1078155215572036","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.37.2649"},{"key":"bibr46-1078155215572036","doi-asserted-by":"crossref","unstructured":"Lonial S, Jagannath S, Moreau P, et\u00a0al. Phase I\/II study of elotuzumab plus lenalidomide\/dexamethasone in relapsed\/refractory multiple myeloma: updated phase II results and Phase I\/II long-term safety.\n                      J Clin Oncol\n                      2013; suppl abstr 8542.","DOI":"10.1200\/jco.2013.31.15_suppl.8542"},{"key":"bibr47-1078155215572036","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.37.7069"},{"key":"bibr48-1078155215572036","unstructured":"Bristol-Myers Squibb. Phase III study of lenalidomide and dexamethasone with or without elotuzumab to treat newly diagnosed, previously untreated multiple myeloma (ELOQUENT-1). In: ClinicalTrials.gov [Internet]. National Library of Medicine (US), http:\/\/clinicaltrials.gov\/ct2\/show\/NCT01335399?term=NCT01335399 NLM Identifier: NCT01335399 (2000, accessed 26 Feb 2014)."},{"key":"bibr49-1078155215572036","unstructured":"Bristol-Myers Squibb. Phase III study of lenalidomide and dexamethasone with or without elotuzumab to treat relapsed or refractory multiple myeloma (ELOQUENT-2). In: ClinicalTrials.gov [Internet]. National Library of Medicine (US), http:\/\/clinicaltrials.gov\/ct2\/show\/NCT01239797?term=NCT01239797 NLM Identifier: NCT01239797 (2000, accessed 26 Feb 2014)."},{"key":"bibr50-1078155215572036","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-14-0695"},{"key":"bibr51-1078155215572036","doi-asserted-by":"crossref","unstructured":"Martin TG, Strickland SA, Glen M, et\u00a0al. SAR650984, a CD38 monoclonal antibody in patients with selected CD38+ hematological malignancies\u2014data from a dose-escalation phase I study. ASH Annual Meeting 2013; Abstr 264.","DOI":"10.1182\/blood.V122.21.284.284"},{"key":"bibr52-1078155215572036","unstructured":"Sanofi. Phase I SAR650984 combination with lenalidomide (LenCombo). ClinicalTrials.gov [Internet]. National Library of Medicine (US), https:\/\/clinicaltrials.gov\/ct2\/show\/NCT01749969?term=sar650984&rank=1. NLM Identifier: NCT01749969 (2000, accessed 15 Dec 2014)."},{"key":"bibr53-1078155215572036","doi-asserted-by":"publisher","DOI":"10.1158\/1535-7163.MCT-11-0433"},{"key":"bibr54-1078155215572036","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2012.07.007"},{"key":"bibr55-1078155215572036","doi-asserted-by":"crossref","unstructured":"Siegel SS, Dimopoulos MA, Yoon SS, et\u00a0al. 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Study of the Bruton\u2019s tyrosine kinase inhibitor in combination with Carfilzomib (Kyprolis), in subjects with relapsed or relapsed and refractory multiple myeloma. In: ClinicalTrials.gov [Internet]. National Library of Medicine (US), http:\/\/clinicaltrials.gov\/ct2\/show\/NCT01962792?term=nct01962792&rank=1. NLM Identifier: NCT01962792 (2000, accessed 16 March 2014)."},{"key":"bibr83-1078155215572036","unstructured":"Chen CI, Gutierrez M, deNully Brown P, et\u00a0al. Antitumor activity of selinexor (KPT-330), a first-in-class oral selective inhibitor of nuclear export (SINE) XPO\n                      1\n                      \/CRM\n                      1\n                      antagonist in patients with relapsed\/refractory multiple myeloma (MM) or Waldenstrom\u2019s macroglobulinemia (WM). ASH Annual Meeting 2013; Abstr 653."},{"key":"bibr84-1078155215572036","unstructured":"University of Chicago. 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