Options for Rescue Treatment of Patients with AL Amyloidosis Exposed to Upfront Daratumumab.

Autor: Bellofiore C; Department of Molecular Medicine, University of Pavia, Pavia, Italy.; Amyloidosis Research and Treatment Center, Fondazione IRCCS Policlinico San Matteo, Viale Golgi, 19, 27100, Pavia, Italy., Palladini G; Department of Molecular Medicine, University of Pavia, Pavia, Italy.; Amyloidosis Research and Treatment Center, Fondazione IRCCS Policlinico San Matteo, Viale Golgi, 19, 27100, Pavia, Italy., Milani P; Department of Molecular Medicine, University of Pavia, Pavia, Italy. paolo.milani@unipv.it.; Amyloidosis Research and Treatment Center, Fondazione IRCCS Policlinico San Matteo, Viale Golgi, 19, 27100, Pavia, Italy. paolo.milani@unipv.it.
Jazyk: angličtina
Zdroj: Current oncology reports [Curr Oncol Rep] 2024 Sep; Vol. 26 (9), pp. 1097-1103. Date of Electronic Publication: 2024 Jun 19.
DOI: 10.1007/s11912-024-01561-2
Abstrakt: Purpose of Review: This review aims to assess the therapeutic strategies available for relapsed/refractory patients with immunoglobulin light chain (AL) amyloidosis who received upfront daratumumab-based regimens.
Recent Findings: The treatment landscape of AL amyloidosis has changed radically thanks to the introduction in the upfront setting of daratumumab in combination with bortezomib, cyclophosphamide and dexamethasone (DaraCyBorD) which improved patients' outcomes increasing the rate of hematologic and organ responses. However, many patients eventually relapse or are refractory to daratumumab and the best salvage therapy is not well defined yet. In this contest, we reviewed the available therapeutic options after daratumumab failure, and we look towards the current advances in Bcl-2 inhibitors, novel immunotherapeutic agents as chimeric antigen receptor (CAR-T) therapy and bispecific antibodies (bsAbs). Relapsed/refractory AL amyloidosis represent an unmet clinical need and novel targeted drugs require urgent prospective assessment.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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