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Erschienen in: Die Onkologie 7/2020

25.05.2020 | Stammzell-Transplantation | CME

Multiples Myelom – dynamische Entwicklungen in Krankheitsverständnis und Therapie

verfasst von: Dr. med. Dr. rer. nat. Torsten Steinbrunn, Prof. Dr. med. Stefan Knop, Prof. Dr. med. Hermann Einsele

Erschienen in: Die Onkologie | Ausgabe 7/2020

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Zusammenfassung

Das multiple Myelom ist eine altersassoziierte maligne Plasmazellerkrankung, die vorrangig im Knochenmark auftritt und zur Verdrängung der normalen Hämatopoese führt. Fortschritte in der molekulargenetischen Diagnostik haben das Verständnis der biologischen Grundlage der Erkrankung entscheidend erweitert. Die schrittweise Einführung von neuen Medikamenten wie Proteasominhibitoren, Immunmodulatoren und monoklonalen Antikörpern sowie der Einsatz wirksamer Kombinationstherapien haben die Prognose auch mehrfach vorbehandelter Patienten deutlich gebessert. Dennoch ist eine Heilung weiterhin nicht möglich. Neue Therapiestrategien vor allem mit immunologischen und zielgerichteten Ansätzen werden die Behandlungsmöglichkeiten in Zukunft bereichern und die Prognose für Patienten mit multiplem Myelom weiter verbessern.
Literatur
1.
Zurück zum Zitat Pulte D, Jansen L, Castro FA et al (2015) Trends in survival of multiple myeloma patients in Germany and the United States in the first decade of the 21st century. Br J Haematol 171(2):189–196PubMedCrossRef Pulte D, Jansen L, Castro FA et al (2015) Trends in survival of multiple myeloma patients in Germany and the United States in the first decade of the 21st century. Br J Haematol 171(2):189–196PubMedCrossRef
2.
Zurück zum Zitat Pawlyn C, Cairns D, Kaiser M et al (2020) The relative importance of factors predicting outcome for myeloma patients at different ages: results from 3894 patients in the Myeloma XI trial. Leukemia 34(2):604–612PubMedCrossRef Pawlyn C, Cairns D, Kaiser M et al (2020) The relative importance of factors predicting outcome for myeloma patients at different ages: results from 3894 patients in the Myeloma XI trial. Leukemia 34(2):604–612PubMedCrossRef
3.
Zurück zum Zitat Bringhen S, Mateos MV, Zweegman S et al (2013) Age and organ damage correlate with poor survival in myeloma patients: meta-analysis of 1435 individual patient data from 4 randomized trials. Haematologica 98(6):980–987PubMedPubMedCentralCrossRef Bringhen S, Mateos MV, Zweegman S et al (2013) Age and organ damage correlate with poor survival in myeloma patients: meta-analysis of 1435 individual patient data from 4 randomized trials. Haematologica 98(6):980–987PubMedPubMedCentralCrossRef
5.
Zurück zum Zitat Pertesi M, Went M, Hansson M, Hemminki K, Houlston RS, Nilsson B (2020) Genetic predisposition for multiple myeloma. Leukemia 34(3):697–708PubMedCrossRef Pertesi M, Went M, Hansson M, Hemminki K, Houlston RS, Nilsson B (2020) Genetic predisposition for multiple myeloma. Leukemia 34(3):697–708PubMedCrossRef
6.
Zurück zum Zitat Nowell PC (1976) The clonal evolution of tumor cell populations. Science 194(4260):23–28PubMedCrossRef Nowell PC (1976) The clonal evolution of tumor cell populations. Science 194(4260):23–28PubMedCrossRef
7.
Zurück zum Zitat Dutta AK, Fink JL, Grady JP et al (2019) Subclonal evolution in disease progression from MGUS/SMM to multiple myeloma is characterised by clonal stability. Leukemia 33(2):457–468PubMedCrossRef Dutta AK, Fink JL, Grady JP et al (2019) Subclonal evolution in disease progression from MGUS/SMM to multiple myeloma is characterised by clonal stability. Leukemia 33(2):457–468PubMedCrossRef
8.
Zurück zum Zitat Capp JP, Bataille R (2018) Multiple myeloma exemplifies a model of cancer based on tissue disruption as the initiator event. Front Oncol 8:355PubMedPubMedCentralCrossRef Capp JP, Bataille R (2018) Multiple myeloma exemplifies a model of cancer based on tissue disruption as the initiator event. Front Oncol 8:355PubMedPubMedCentralCrossRef
9.
Zurück zum Zitat Walker BA, Wardell CP, Melchor L et al (2014) Intraclonal heterogeneity is a critical early event in the development of myeloma and precedes the development of clinical symptoms. Leukemia 28(2):384–390PubMedCrossRef Walker BA, Wardell CP, Melchor L et al (2014) Intraclonal heterogeneity is a critical early event in the development of myeloma and precedes the development of clinical symptoms. Leukemia 28(2):384–390PubMedCrossRef
10.
Zurück zum Zitat Rasche L, Chavan SS, Stephens OW et al (2017) Spatial genomic heterogeneity in multiple myeloma revealed by multi-region sequencing. Nat Commun 8(1):268PubMedPubMedCentralCrossRef Rasche L, Chavan SS, Stephens OW et al (2017) Spatial genomic heterogeneity in multiple myeloma revealed by multi-region sequencing. Nat Commun 8(1):268PubMedPubMedCentralCrossRef
11.
Zurück zum Zitat Rajkumar SV, Dimopoulos MA, Palumbo A et al (2014) International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol 15(12):e538–e548PubMedCrossRef Rajkumar SV, Dimopoulos MA, Palumbo A et al (2014) International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol 15(12):e538–e548PubMedCrossRef
12.
Zurück zum Zitat Lapa C, Schreder M, Luckerath K et al (2018) [11C]Methionine emerges as a new biomarker for tracking active myeloma lesions. Br J Haematol 181(5):701–703PubMedCrossRef Lapa C, Schreder M, Luckerath K et al (2018) [11C]Methionine emerges as a new biomarker for tracking active myeloma lesions. Br J Haematol 181(5):701–703PubMedCrossRef
13.
Zurück zum Zitat Greipp PR, San Miguel J, Durie BG et al (2005) International staging system for multiple myeloma. J Clin Oncol 23(15):3412–3420PubMedCrossRef Greipp PR, San Miguel J, Durie BG et al (2005) International staging system for multiple myeloma. J Clin Oncol 23(15):3412–3420PubMedCrossRef
14.
Zurück zum Zitat Palumbo A, Avet-Loiseau H, Oliva S et al (2015) Revised international staging system for multiple myeloma: a report from International Myeloma Working Group. J Clin Oncol 33(26):2863–2869PubMedPubMedCentralCrossRef Palumbo A, Avet-Loiseau H, Oliva S et al (2015) Revised international staging system for multiple myeloma: a report from International Myeloma Working Group. J Clin Oncol 33(26):2863–2869PubMedPubMedCentralCrossRef
15.
Zurück zum Zitat Landgren O, Devlin S, Boulad M, Mailankody S (2016) Role of MRD status in relation to clinical outcomes in newly diagnosed multiple myeloma patients: a meta-analysis. Bone Marrow Transplant 51(12):1565–1568PubMedPubMedCentralCrossRef Landgren O, Devlin S, Boulad M, Mailankody S (2016) Role of MRD status in relation to clinical outcomes in newly diagnosed multiple myeloma patients: a meta-analysis. Bone Marrow Transplant 51(12):1565–1568PubMedPubMedCentralCrossRef
16.
Zurück zum Zitat Kumar S, Paiva B, Anderson KC et al (2016) International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma. Lancet Oncol 17(8):e328–e346CrossRefPubMed Kumar S, Paiva B, Anderson KC et al (2016) International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma. Lancet Oncol 17(8):e328–e346CrossRefPubMed
17.
Zurück zum Zitat Nishimura KK, Barlogie B, van Rhee F et al (2020) Long-term outcomes after autologous stem cell transplantation for multiple myeloma. Blood Adv 4(2):422–431PubMedPubMedCentralCrossRef Nishimura KK, Barlogie B, van Rhee F et al (2020) Long-term outcomes after autologous stem cell transplantation for multiple myeloma. Blood Adv 4(2):422–431PubMedPubMedCentralCrossRef
18.
Zurück zum Zitat Einsele H, Engelhardt M, Tapprich C et al (2017) Phase II study of bortezomib, cyclophosphamide and dexamethasone as induction therapy in multiple myeloma: DSMM XI trial. Br J Haematol 179(4):586–597PubMedCrossRef Einsele H, Engelhardt M, Tapprich C et al (2017) Phase II study of bortezomib, cyclophosphamide and dexamethasone as induction therapy in multiple myeloma: DSMM XI trial. Br J Haematol 179(4):586–597PubMedCrossRef
19.
Zurück zum Zitat Moreau P, Attal M, Hulin C et al (2019) Bortezomib, thalidomide, and dexamethasone with or without daratumumab before and after autologous stem-cell transplantation for newly diagnosed multiple myeloma (CASSIOPEIA): a randomised, open-label, phase 3 study. Lancet 394(10192):29–38PubMedCrossRef Moreau P, Attal M, Hulin C et al (2019) Bortezomib, thalidomide, and dexamethasone with or without daratumumab before and after autologous stem-cell transplantation for newly diagnosed multiple myeloma (CASSIOPEIA): a randomised, open-label, phase 3 study. Lancet 394(10192):29–38PubMedCrossRef
20.
Zurück zum Zitat Sonneveld P, Broijl A, Gay F et al (2019) Bortezomib, lenalidomide, and dexamethasone (VRd) ± daratumumab (DARA) in patients (pts) with transplant-eligible (TE) newly diagnosed multiple myeloma (NDMM): A multicenter, randomized, phase III study (PERSEUS). J Clin Oncol 37(15_Suppl):TPS8055 (Abstract)CrossRef Sonneveld P, Broijl A, Gay F et al (2019) Bortezomib, lenalidomide, and dexamethasone (VRd) ± daratumumab (DARA) in patients (pts) with transplant-eligible (TE) newly diagnosed multiple myeloma (NDMM): A multicenter, randomized, phase III study (PERSEUS). J Clin Oncol 37(15_Suppl):TPS8055 (Abstract)CrossRef
21.
Zurück zum Zitat Orlowski RZ, Goldschmidt H, Cavo M et al (2018) Phase III (IMROZ) study design: Isatuximab plus bortezomib (V), lenalidomide (R), and dexamethasone (d) vs VRd in transplant-ineligible patients (pts) with newly diagnosed multiple myeloma (NDMM). J Clin Oncol 36(15_Suppl):TPS8055 (Abstract)CrossRef Orlowski RZ, Goldschmidt H, Cavo M et al (2018) Phase III (IMROZ) study design: Isatuximab plus bortezomib (V), lenalidomide (R), and dexamethasone (d) vs VRd in transplant-ineligible patients (pts) with newly diagnosed multiple myeloma (NDMM). J Clin Oncol 36(15_Suppl):TPS8055 (Abstract)CrossRef
23.
Zurück zum Zitat Cavo M, Patriarca F, Zamagni E et al (2017) Double Autologous stem cell transplantation significantly prolongs progression-free survival and overall survival in comparison with single Autotransplantation in newly diagnosed multiple myeloma: an analysis of phase 3 EMN02/HO95 study. Blood 130(Suppl.1):401 (Abstract) Cavo M, Patriarca F, Zamagni E et al (2017) Double Autologous stem cell transplantation significantly prolongs progression-free survival and overall survival in comparison with single Autotransplantation in newly diagnosed multiple myeloma: an analysis of phase 3 EMN02/HO95 study. Blood 130(Suppl.1):401 (Abstract)
24.
Zurück zum Zitat Knop S, Engelhardt M, Liebisch P et al (2019) Allogeneic transplantation in multiple myeloma: long-term follow-up and cytogenetic subgroup analysis. Leukemia 33(11):2710–2719PubMedCrossRef Knop S, Engelhardt M, Liebisch P et al (2019) Allogeneic transplantation in multiple myeloma: long-term follow-up and cytogenetic subgroup analysis. Leukemia 33(11):2710–2719PubMedCrossRef
25.
Zurück zum Zitat Jackson GH, Davies FE, Pawlyn C et al (2019) Lenalidomide maintenance versus observation for patients with newly diagnosed multiple myeloma (Myeloma XI): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 20(1):57–73PubMedPubMedCentralCrossRef Jackson GH, Davies FE, Pawlyn C et al (2019) Lenalidomide maintenance versus observation for patients with newly diagnosed multiple myeloma (Myeloma XI): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 20(1):57–73PubMedPubMedCentralCrossRef
26.
Zurück zum Zitat McCarthy PL, Holstein SA, Petrucci MT et al (2017) Lenalidomide maintenance after Autologous stem-cell transplantation in newly diagnosed multiple myeloma: a meta-analysis. J Clin Oncol 35(29):3279–3289PubMedPubMedCentralCrossRef McCarthy PL, Holstein SA, Petrucci MT et al (2017) Lenalidomide maintenance after Autologous stem-cell transplantation in newly diagnosed multiple myeloma: a meta-analysis. J Clin Oncol 35(29):3279–3289PubMedPubMedCentralCrossRef
27.
Zurück zum Zitat Dimopoulos MA, Gay F, Schjesvold F et al (2019) Oral ixazomib maintenance following autologous stem cell transplantation (TOURMALINE-MM3): a double-blind, randomised, placebo-controlled phase 3 trial. Lancet 393(10168):253–264PubMedCrossRef Dimopoulos MA, Gay F, Schjesvold F et al (2019) Oral ixazomib maintenance following autologous stem cell transplantation (TOURMALINE-MM3): a double-blind, randomised, placebo-controlled phase 3 trial. Lancet 393(10168):253–264PubMedCrossRef
28.
Zurück zum Zitat Facon T, Kumar S, Plesner T et al (2019) Daratumumab plus Lenalidomide and Dexamethasone for untreated myeloma. N Engl J Med 380(22):2104–2115CrossRefPubMed Facon T, Kumar S, Plesner T et al (2019) Daratumumab plus Lenalidomide and Dexamethasone for untreated myeloma. N Engl J Med 380(22):2104–2115CrossRefPubMed
29.
Zurück zum Zitat Mateos MV, Dimopoulos MA, Cavo M et al (2018) Daratumumab plus Bortezomib, Melphalan, and Prednisone for untreated myeloma. N Engl J Med 378(6):518–528CrossRefPubMed Mateos MV, Dimopoulos MA, Cavo M et al (2018) Daratumumab plus Bortezomib, Melphalan, and Prednisone for untreated myeloma. N Engl J Med 378(6):518–528CrossRefPubMed
30.
Zurück zum Zitat Usmani SZ, Nahi H, Mateos MV et al (2019) Subcutaneous delivery of daratumumab in relapsed or refractory multiple myeloma. Blood 134(8):668–677PubMedPubMedCentralCrossRef Usmani SZ, Nahi H, Mateos MV et al (2019) Subcutaneous delivery of daratumumab in relapsed or refractory multiple myeloma. Blood 134(8):668–677PubMedPubMedCentralCrossRef
31.
Zurück zum Zitat Offidani M, Corvatta L, Gentili S (2018) Triplet vs. doublet drug regimens for managing multiple myeloma. Expert Opin Pharmacother 19(2):137–149PubMedCrossRef Offidani M, Corvatta L, Gentili S (2018) Triplet vs. doublet drug regimens for managing multiple myeloma. Expert Opin Pharmacother 19(2):137–149PubMedCrossRef
32.
Zurück zum Zitat Palumbo A, Chanan-Khan A, Weisel K et al (2016) Daratumumab, Bortezomib, and Dexamethasone for multiple myeloma. N Engl J Med 375(8):754–766PubMedCrossRef Palumbo A, Chanan-Khan A, Weisel K et al (2016) Daratumumab, Bortezomib, and Dexamethasone for multiple myeloma. N Engl J Med 375(8):754–766PubMedCrossRef
33.
Zurück zum Zitat Dimopoulos MA, Oriol A, Nahi H et al (2016) Daratumumab, Lenalidomide, and Dexamethasone for multiple myeloma. N Engl J Med 375(14):1319–1331CrossRefPubMed Dimopoulos MA, Oriol A, Nahi H et al (2016) Daratumumab, Lenalidomide, and Dexamethasone for multiple myeloma. N Engl J Med 375(14):1319–1331CrossRefPubMed
34.
Zurück zum Zitat Lonial S, Dimopoulos M, Palumbo A et al (2015) Elotuzumab therapy for relapsed or refractory multiple myeloma. N Engl J Med 373(7):621–631PubMedCrossRef Lonial S, Dimopoulos M, Palumbo A et al (2015) Elotuzumab therapy for relapsed or refractory multiple myeloma. N Engl J Med 373(7):621–631PubMedCrossRef
35.
Zurück zum Zitat Dimopoulos MA, Dytfeld D, Grosicki S et al (2018) Elotuzumab plus Pomalidomide and Dexamethasone for multiple myeloma. N Engl J Med 379(19):1811–1822PubMedCrossRef Dimopoulos MA, Dytfeld D, Grosicki S et al (2018) Elotuzumab plus Pomalidomide and Dexamethasone for multiple myeloma. N Engl J Med 379(19):1811–1822PubMedCrossRef
36.
Zurück zum Zitat Attal M, Richardson PG, Rajkumar SV et al (2019) Isatuximab plus pomalidomide and low-dose dexamethasone versus pomalidomide and low-dose dexamethasone in patients with relapsed and refractory multiple myeloma (ICARIA-MM): a randomised, multicentre, open-label, phase 3 study. Lancet 394(10214):2096–2107PubMedCrossRef Attal M, Richardson PG, Rajkumar SV et al (2019) Isatuximab plus pomalidomide and low-dose dexamethasone versus pomalidomide and low-dose dexamethasone in patients with relapsed and refractory multiple myeloma (ICARIA-MM): a randomised, multicentre, open-label, phase 3 study. Lancet 394(10214):2096–2107PubMedCrossRef
38.
Zurück zum Zitat Lonial S, Lee HC, Badros A et al (2020) Belantamab mafodotin for relapsed or refractory multiple myeloma (DREAMM-2): a two-arm, randomised, open-label, phase 2 study. Lancet Oncol 21(2):207–221PubMedCrossRef Lonial S, Lee HC, Badros A et al (2020) Belantamab mafodotin for relapsed or refractory multiple myeloma (DREAMM-2): a two-arm, randomised, open-label, phase 2 study. Lancet Oncol 21(2):207–221PubMedCrossRef
39.
Zurück zum Zitat Topp MS, Duell J, Zugmaier G et al (2020) Anti-B-cell maturation antigen BiTE molecule AMG 420 induces responses in multiple myeloma. J Clin Oncol 38(8):775–783PubMedCrossRef Topp MS, Duell J, Zugmaier G et al (2020) Anti-B-cell maturation antigen BiTE molecule AMG 420 induces responses in multiple myeloma. J Clin Oncol 38(8):775–783PubMedCrossRef
40.
Zurück zum Zitat Brudno JN, Maric I, Hartman SD et al (2018) T cells genetically modified to express an anti-B-cell maturation antigen chimeric antigen receptor cause remissions of poor-prognosis relapsed multiple myeloma. J Clin Oncol 36(22):2267–2280PubMedPubMedCentralCrossRef Brudno JN, Maric I, Hartman SD et al (2018) T cells genetically modified to express an anti-B-cell maturation antigen chimeric antigen receptor cause remissions of poor-prognosis relapsed multiple myeloma. J Clin Oncol 36(22):2267–2280PubMedPubMedCentralCrossRef
41.
Zurück zum Zitat Raje N, Berdeja J, Lin Y et al (2019) Anti-BCMA CAR T‑cell therapy bb2121 in relapsed or refractory multiple myeloma. N Engl J Med 380(18):1726–1737PubMedPubMedCentralCrossRef Raje N, Berdeja J, Lin Y et al (2019) Anti-BCMA CAR T‑cell therapy bb2121 in relapsed or refractory multiple myeloma. N Engl J Med 380(18):1726–1737PubMedPubMedCentralCrossRef
42.
Zurück zum Zitat Chari A, Vogl DT, Gavriatopoulou M et al (2019) Oral Selinexor-Dexamethasone for triple-class refractory multiple myeloma. N Engl J Med 381(8):727–738PubMedCrossRef Chari A, Vogl DT, Gavriatopoulou M et al (2019) Oral Selinexor-Dexamethasone for triple-class refractory multiple myeloma. N Engl J Med 381(8):727–738PubMedCrossRef
43.
Zurück zum Zitat Jakubowiak AJ, Jasielec JK, Rosenbaum CA et al (2019) Phase 1 study of selinexor plus carfilzomib and dexamethasone for the treatment of relapsed/refractory multiple myeloma. Br J Haematol 186(4):549–560PubMedPubMedCentralCrossRef Jakubowiak AJ, Jasielec JK, Rosenbaum CA et al (2019) Phase 1 study of selinexor plus carfilzomib and dexamethasone for the treatment of relapsed/refractory multiple myeloma. Br J Haematol 186(4):549–560PubMedPubMedCentralCrossRef
45.
Zurück zum Zitat Moreau P, Harrison S, Cavo M et al (2019) Updated analysis of Bellini, a phase 3 study of Venetoclax or placebo in combination with Bortezomib and Dexamethasone in patients with relapsed/refractory multiple myeloma. Blood 134:1888 (Abstrac)CrossRef Moreau P, Harrison S, Cavo M et al (2019) Updated analysis of Bellini, a phase 3 study of Venetoclax or placebo in combination with Bortezomib and Dexamethasone in patients with relapsed/refractory multiple myeloma. Blood 134:1888 (Abstrac)CrossRef
46.
Zurück zum Zitat Harrison S, Cavo M, de la Rubia J et al (2019) T(11;14) and high BCL2 expression are predictive Biomarkers of response to Venetoclax in combination with Bortezomib and Dexamethasone in patients with relapsed/refractory multiple myeloma: Biomarker analyses from the phase 3 Bellini study. Blood 134(Suppl.1):142 (Abstract)CrossRef Harrison S, Cavo M, de la Rubia J et al (2019) T(11;14) and high BCL2 expression are predictive Biomarkers of response to Venetoclax in combination with Bortezomib and Dexamethasone in patients with relapsed/refractory multiple myeloma: Biomarker analyses from the phase 3 Bellini study. Blood 134(Suppl.1):142 (Abstract)CrossRef
48.
Zurück zum Zitat Lonial S, van de Donk NWCJ, Popat R et al (2019) First clinical (phase 1b/2a) study of iberdomide (CC-220; IBER), a CELMoD, in combination with dexamethasone (DEX) in patients (pts) with relapsed/refractory multiple myeloma (RRMM). J Clin Oncol 37(15_Suppl):8006 (Abstract)CrossRef Lonial S, van de Donk NWCJ, Popat R et al (2019) First clinical (phase 1b/2a) study of iberdomide (CC-220; IBER), a CELMoD, in combination with dexamethasone (DEX) in patients (pts) with relapsed/refractory multiple myeloma (RRMM). J Clin Oncol 37(15_Suppl):8006 (Abstract)CrossRef
49.
Zurück zum Zitat Richardson PG, Oriol A, Larocca A et al (2019) HORIZON (OP-106): updated efficacy and safety of Melflufen in relapsed/refractory multiple myeloma (RRMM) refractory to Daratumumab (DARA) and/or Pomalidomide (POM). EHA Library 267359:S1605 (Abstract) Richardson PG, Oriol A, Larocca A et al (2019) HORIZON (OP-106): updated efficacy and safety of Melflufen in relapsed/refractory multiple myeloma (RRMM) refractory to Daratumumab (DARA) and/or Pomalidomide (POM). EHA Library 267359:S1605 (Abstract)
50.
Zurück zum Zitat Morgan GJ, Davies FE, Gregory WM et al (2010) First-line treatment with zoledronic acid as compared with clodronic acid in multiple myeloma (MRC Myeloma IX): a randomised controlled trial. Lancet 376(9757):1989–1999CrossRefPubMed Morgan GJ, Davies FE, Gregory WM et al (2010) First-line treatment with zoledronic acid as compared with clodronic acid in multiple myeloma (MRC Myeloma IX): a randomised controlled trial. Lancet 376(9757):1989–1999CrossRefPubMed
51.
Zurück zum Zitat Raje N, Terpos E, Willenbacher W et al (2018) Denosumab versus zoledronic acid in bone disease treatment of newly diagnosed multiple myeloma: an international, double-blind, double-dummy, randomised, controlled, phase 3 study. Lancet Oncol 19(3):370–381PubMedCrossRef Raje N, Terpos E, Willenbacher W et al (2018) Denosumab versus zoledronic acid in bone disease treatment of newly diagnosed multiple myeloma: an international, double-blind, double-dummy, randomised, controlled, phase 3 study. Lancet Oncol 19(3):370–381PubMedCrossRef
Metadaten
Titel
Multiples Myelom – dynamische Entwicklungen in Krankheitsverständnis und Therapie
verfasst von
Dr. med. Dr. rer. nat. Torsten Steinbrunn
Prof. Dr. med. Stefan Knop
Prof. Dr. med. Hermann Einsele
Publikationsdatum
25.05.2020
Verlag
Springer Medizin
Erschienen in
Die Onkologie / Ausgabe 7/2020
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-020-00780-z

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