Mamatkulova Feruza Khaydarovna (1), Yuldosheva Shakhnosa Gayrat kizi (2), Zokhirova Durdona Erkinovna (3), Khasanova Eʼzoza Nurbek kizi (4), Eshkobilov Bekhruzjon Shukhrat ugli (5)
Multiple myeloma (MM) remains largely incurable despite advances in proteasome inhibitor, immunomodulatory drug, and anti-CD38 antibody therapies. Recent years have seen the advent of revolutionary immunotherapies – notably CAR T-cells, bispecific T-cell engagers, monoclonal antibodies (MoAbs), and antibody–drug conjugates (ADCs) – that target myeloma cells in novel ways. These modalities have produced unprecedented response rates in heavily pretreated patients but also introduce unique toxicity and cost challenges. For example, BCMA-directed CAR T-cell products yield high overall response rates (e.g. ORR ~70–90%) with deep remissions, and the BCMA×CD3 bispecific teclistamab achieves ORRs ~63–67% in triple-class refractory MM. Daratumumab and isatuximab (anti-CD38 MoAbs) have been integrated into frontline regimens to deepen responses, while the anti-BCMA ADC belantamab mafodotin has shown ~32% ORR albeit with notable ocular toxicity. This review summarizes current standard treatments and focuses on innovative approaches – including their clinical trial results, safety profiles, and practical challenges – highlighting ongoing research directions for the hematology community.
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