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Multiple Myeloma: Available Therapies and Causes of Drug Resistance

Multiple myeloma (MM) is the second most common blood cancer. Treatments for MM include corticosteroids, alkylating agents, anthracyclines, proteasome inhibitors, immunomodulatory drugs, histone deacetylase inhibitors and monoclonal antibodies. Survival outcomes have improved substantially due to th...

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Autores principales: Pinto, Vanessa, Bergantim, Rui, Caires, Hugo R., Seca, Hugo, Guimarães, José E., Vasconcelos, M. Helena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7072128/
https://www.ncbi.nlm.nih.gov/pubmed/32050631
http://dx.doi.org/10.3390/cancers12020407
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author Pinto, Vanessa
Bergantim, Rui
Caires, Hugo R.
Seca, Hugo
Guimarães, José E.
Vasconcelos, M. Helena
author_facet Pinto, Vanessa
Bergantim, Rui
Caires, Hugo R.
Seca, Hugo
Guimarães, José E.
Vasconcelos, M. Helena
author_sort Pinto, Vanessa
collection PubMed
description Multiple myeloma (MM) is the second most common blood cancer. Treatments for MM include corticosteroids, alkylating agents, anthracyclines, proteasome inhibitors, immunomodulatory drugs, histone deacetylase inhibitors and monoclonal antibodies. Survival outcomes have improved substantially due to the introduction of many of these drugs allied with their rational use. Nonetheless, MM patients successively relapse after one or more treatment regimens or become refractory, mostly due to drug resistance. This review focuses on the main drugs used in MM treatment and on causes of drug resistance, including cytogenetic, genetic and epigenetic alterations, abnormal drug transport and metabolism, dysregulation of apoptosis, autophagy activation and other intracellular signaling pathways, the presence of cancer stem cells, and the tumor microenvironment. Furthermore, we highlight the areas that need to be further clarified in an attempt to identify novel therapeutic targets to counteract drug resistance in MM patients.
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spelling pubmed-70721282020-03-19 Multiple Myeloma: Available Therapies and Causes of Drug Resistance Pinto, Vanessa Bergantim, Rui Caires, Hugo R. Seca, Hugo Guimarães, José E. Vasconcelos, M. Helena Cancers (Basel) Review Multiple myeloma (MM) is the second most common blood cancer. Treatments for MM include corticosteroids, alkylating agents, anthracyclines, proteasome inhibitors, immunomodulatory drugs, histone deacetylase inhibitors and monoclonal antibodies. Survival outcomes have improved substantially due to the introduction of many of these drugs allied with their rational use. Nonetheless, MM patients successively relapse after one or more treatment regimens or become refractory, mostly due to drug resistance. This review focuses on the main drugs used in MM treatment and on causes of drug resistance, including cytogenetic, genetic and epigenetic alterations, abnormal drug transport and metabolism, dysregulation of apoptosis, autophagy activation and other intracellular signaling pathways, the presence of cancer stem cells, and the tumor microenvironment. Furthermore, we highlight the areas that need to be further clarified in an attempt to identify novel therapeutic targets to counteract drug resistance in MM patients. MDPI 2020-02-10 /pmc/articles/PMC7072128/ /pubmed/32050631 http://dx.doi.org/10.3390/cancers12020407 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Pinto, Vanessa
Bergantim, Rui
Caires, Hugo R.
Seca, Hugo
Guimarães, José E.
Vasconcelos, M. Helena
Multiple Myeloma: Available Therapies and Causes of Drug Resistance
title Multiple Myeloma: Available Therapies and Causes of Drug Resistance
title_full Multiple Myeloma: Available Therapies and Causes of Drug Resistance
title_fullStr Multiple Myeloma: Available Therapies and Causes of Drug Resistance
title_full_unstemmed Multiple Myeloma: Available Therapies and Causes of Drug Resistance
title_short Multiple Myeloma: Available Therapies and Causes of Drug Resistance
title_sort multiple myeloma: available therapies and causes of drug resistance
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7072128/
https://www.ncbi.nlm.nih.gov/pubmed/32050631
http://dx.doi.org/10.3390/cancers12020407
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