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Multiple myeloma drugs fall into various drug classes, including proteasome inhibitors (PIs), immunomodulatory drugs (IMiDs®), alkylating agents, corticosteroids, bisphosphonates, and monoclonal antibodies (MAbs).

Multiple Myeloma Drugs

In this section, medications are categorized according to their drug class. 

Proteasome inhibitors (PI)

  • NINLARO®  |  ixazomib  |  I
    Ninlaro (ixazomib) was approved by the U.S. Food and Drug Administration (FDA) in 2015 for the treatment of adult patients with myeloma who have received at least 1 prior therapy. Ninlaro is indicated in combination with Revlimid® (lenalidomide) and the steroid dexamethasone, a “triplet” (3-drug) combination known as “IRd.” Ninlaro is the third proteasome inhibitor approved by the FDA since 2003, and it is the first proteasome inhibitor that is taken orally by mouth.
  • KYPROLIS®  |  carfilzomib  |  cfz, car, K
    Kyprolis (carfilzomib) is a proteasome inhibitor approved by the U.S. Food and Drug Administration (FDA) in 2012 for the treatment of relapsed or refractory myeloma. Kyprolis works by blocking the activity of enzyme complexes called proteasomes, which are important for maintaining balance within the cell and for regulating cell growth. Myeloma cells are more sensitive to proteasome inhibition than normal cells, so the myeloma cells die while normal cells are able to recover. Kyprolis is given by intravenous (IV) infusion at a doctor’s office, hospital, or clinic.
  • VELCADE®  |  bortezomib  |  btz, bor, V
    Velcade (bortezomib) is an anti-cancer agent available for injection into a vein (intravenously or IV) or under the skin (subcutaneously). Velcade is indicated for the treatment of newly diagnosed and relapsed or refractory myeloma.

Immunomodulators (IMiD)

  • POMALYST®  |  pomalidomide  |  pom, P
    Pomalyst (pomalidomide) is an oral treatment for multiple myeloma indicated, in combination with dexamethasone, for patients with multiple myeloma who have received at least two prior therapies including lenalidomide and a proteasome inhibitor.
  • REVLIMID®  |  lenalidomide  |  len, R
    Revlimid (lenalidomide), an immunomodulatory drug (IMiD®), is the first oral medication that was developed for treatment of multiple myeloma. It is used in the newly diagnosed, maintenance therapy, and relapsed and/or refractory settings.
  • THALOMID®  |  thalidomide  |  thal, T
    Thalomid (thalidomide) is an oral immunomodulatory drug, an agent that can modify or regulate the immune system. It has both anti-inflammatory and anti-cancer activities. Thalidomide was first used to treat multiple myeloma in 1997.

Monoclonal antibodies (MAb)

  • DARZALEX®  |  daratumumab  |  dara
    Darzalex (daratumumab) is the first FDA-approved monoclonal antibody that targets the CD38 protein on the surface of myeloma cells. It is approved for adult patients with myeloma in multiple disease settings, from the newly diagnosed to the relapsed/refractory. Darzalex is administered intravenously.
  • DARZALEX FASPRO® |  daratumumab and hyaluronidase-fihj
    Darzalex Faspro (daratumumab and hyaluronidase-fihj) is a new formulation of Darzalex that is given as an abdominal injection under the skin. It is approved for adult patients with multiple myeloma in multiple disease settings from the newly diagnosed to the relapsed/refractory.  .
  • EMPLICITI®  |  elotuzumab  |  elo, E
    Empliciti (elotuzumab) is a monoclonal antibody. It is an intravenously infused prescription medicine used to treat multiple myeloma in combination with the medicines Revlimid® (lenalidomide) and dexamethasone, in people who have received one to three prior treatments for their disease. It is also approved for use in combination with Pomalyst® and dexamethasone in patients with myeloma who have received at least 2 prior therapies including Revlimid and a proteasome inhibitor.
  • SARCLISA®  |  isatuximab-ifrc
    Sarclisa (isatuximab-ifrc) is a novel anti-CD38 monoclonal antibody. It is given as an intravenous infusion every week for 4 weeks, then every 2 weeks. It is administered as part of a three-drug regimen known as Isa-Pd, or Sarclisa plus Pomalyst® and dexemthasone. 

Bispecific antibodies

  • ELREXFIO™| (elranatamab-bcmm)
    Elrexfio (elranatamab-bcmm) is a B-cell maturation antigen (BCMA)-CD3-directed bispecific antibody immunotherapy. In August 2023, the U.S. FDA granted accelerated approval of Elrexfio for the treatment of adult patients with relapsed or refractory multiple myeloma (RRMM) who have received at least four prior lines of therapy, including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody.
  • TALVEY™| (talquetamab)
    Talvey (talquetamab) is indicated for adult patients with relapsed or refractory myeloma who have had at least four prior lines of therapy, including a protea­some inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody. Talvey is a bispecific monoclonal antibody with a novel target, GPRC5D. Unlike CAR T-cell therapy that requires several weeks for the collection, engineering, and manufacturing of the patient’s T cells, Tecvayli engages the patient’s T cells to kill myeloma cells directly after injection. 

  • TECVAYLI™| (teclistamab-cqyv)
    Tecvayli (teclistamab-cqyv) is indicated for adult patients with relapsed or refractory myeloma who have had at least four prior lines of therapy, including a protea­some inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody. Tecvayli is the first-in-class bispecific B-cell maturation antigen (BCMA)-directed CD3 T-cell engager. The “off-the-shelf” availability of Tecvayli makes it easier to access treatment. Unlike CAR T-cell therapy that requires several weeks for the collection, engineering, and manufacturing of the patient’s T cells, Tecvayli engages the patient’s T cells to kill myeloma cells directly after injection. 

CAR T-cell therapies

  • ABECMA®  |  idecabtagene vicleucel  |  ide-cel
    Abecma (idecabtagene vicleucel), a personalized immune cell therapy delivered as a one-time infusion, is approved for use in adult patients with relapsed and refractory myeloma who have had four or more prior lines of therapy that include three major drug classes, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 monoclonal antibody. On April 4, 2024, the FDA approved Abecma for the treatment of relapsed or refractory multiple myeloma (RRMM) after 2 or more prior lines of therapy including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 monoclonal antibody. This approval is based on data from the KarMMa-3 phase III clinical trial.
  • CARVYKTI™  |  ciltacabtagene autoleucel  |  cilta-cel
    Carvykti (ciltacabtagene autoleucel, cilta-cel) a personalized immune cell therapy delivered as a one-time infusion, is approved for use in adult patients with relapsed or refractory multiple myeloma, who have had four or more prior lines of therapy that include three major drug classes, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 monoclonal antibody. Carvykti is manufactured for each individual patient using the patient’s own white blood cells (T cells). On April 5, 2024, the FDA approved Carvykti for the treatment of patients with RRMM who have received at least 1 prior line of therapy, including an immunomodulatory agent and a proteasome inhibitor, and are refractory to Revlimid. Carvykti is the first and only B-cell maturation antigen (BCMA)-targeted therapy approved for the  treatment of patients with myeloma as early as first relapse. The new FDA approval is based on data from the CARTITUDE-4 phase III clinical trial. 

Antibody-drug conjugates

  • BLENREP®  |  belantamab mafodotin-blmf  |  bela, belamaf
    In November 2022, GSK announced it has initiated the process for withdrawal of the U.S. marketing authorization for Blenrep following the request of the FDA. Blenrep is no longer a choice in the care of myeloma patients, but some patients may be continuing care on Blenrep. Previously, this BCMA-directed antibody-drug conjugate (ADC) was indicated for the treatment of adult patients with relapsed or refractory myeloma who have received at least 4 prior therapies including an anti-CD38 monoclonal antibody, a proteasome inhibitor, and an immunomodulatory agent. In November 2023, GSK announced more news about Blenrep here. Yet, by early 2024, the DREAMM-7 and DREAMM-8 clinical trials demonstrated positive results for the use of Blenrep. Read about the DREAMM-7 results here and DREAMM-8 results here.

Nuclear export inhibitor

  • XPOVIO®  |  selinexor
    Xpovio® (selinexor) is a selective inhibitor of nuclear export (SINE) compound. In 2019, Xpovio became the first medication in this drug class to receive approval from the U.S. Food and Drug Administration (FDA). Xpovio was initially used for the treatment of relapsed/refractory multiple myeloma (RRMM) in combination with dexamethasone [Xd] or with Velcade® (bortezo­mib) + dexamethasone [XVd]. In 2024, Xpovio is also listed in the National Comprehensive Cancer Network (NCCN) Guidelines for myeloma in combinations with Kyprolis® (carfilzomib) [XKd] or Pomalyst® (pomalidomide) [XPd] or Darzalex® (daratumumab) [XDd, DXd, or Dara-Xd]y.

Alkylating agents

  • ALKERAN®, ALPHALAN®  | melphalan, mel, M
    Alkeran (melphalan) is a chemotherapy drug commonly used in treating multiple myeloma. In the U.S., melphalan is most commonly used in the treatment of MM as the conditioning agent in autologous stem cell transplant. It is given as an intravenous infusion (IV) at a high dose to ablate (wipe out the cells within) the bone marrow, where myeloma grows, the day before the patient's own hematopoietic (blood-making) stem cells are given back to restore bone marrow function. It is also used, most commonly outside the U.S., as an oral agent to treat myeloma in combination with Velcade® and prednisone (VMP), and in combination with thalidomide and prednisone (MPT).
     
  • CYTOXAN® (cyclophosphamide) |  CTX, Cy, C
    Cyclophosphamide was first approved by the U.S. Food and Drug Administration (FDA) in 1959, and is still widely used to treat multiple myeloma, as well as many other types of cancer and autoimmune diseases. As a first-line therapy, it is most commonly given orally in combination with Velcade (bortezomib) and dexamethasone (CyBorD or VCd). Cyclophosphamide is also given orally at relapse in combination with Revlimid® and dexamethasone (CRd) or Pomalyst® and dexamethasone (CPd). A Cyclophosphamide infusion, or intravenous (IV) Cyclophosphamide, can also be used as part of the stem cell harvesting process in combination with colony-stimulating factors.

Corticosteroids

  • DECADRON®  |  dexamethasone  |  D, d, dex, DXM
    Dexamethasone (which is sometimes called “dex” for short) is also known by the brand names Decadron®, Dexasone®, Diodex®, Hexadrol®, and Maxidex®. It is one of the most frequently used medications in the treatment of multiple myeloma
  • DELTASONE®  |  prednisone  |  pred, P
    Prednisone belongs to a class of drugs known as corticosteroids. It decreases your immune system's response to various diseases to reduce symptoms such as swelling and allergic-type reactions.
  • MEDROL®  |  methylprednisolone
    Methylprednisolone is used to decrease your immune system's response to various diseases to reduce symptoms such as swelling, pain, and allergic-type reactions. 

Bone-modifying agents

  • XGEVA®  |  denosumab
    Denosumab (trade names Prolia and Xgeva) is a human monoclonal antibody for the treatment of osteoporosis, treatment-induced bone loss, metastases to bone, and giant cell tumor of bone.
  • ZOMETA®  |  zoledronic acid  |  zol
    Zoledronic acid is also used with cancer chemotherapy to treat bone problems that may occur with multiple myeloma and other types of cancer (such as breast, lung) that have spread to the bones.
  • AREDIA®  |  pamidronate  |  pmd
    Pamidronate is used to treat high blood calcium levels and certain bone problems (bone metastases/lesions) that may occur with some types of cancer.

CELMoDs

CELMoDs, iberdomide and megzidomide, are in clinical trials. To learn more about these therapies, visit iberdomide and megzidomide

Guide to Myeloma Drug Names

Multiple myeloma treatments have evolved over the last thirty years. Since 2009 alone, more than a dozen new treatments have been developed for the disease. This table provides a comprehensive list of many of the drugs that have been used to treat myeloma through time. You may want to reference this list if you are a patient researching clinical trials or if you are a myeloma researcher.

 

 

Download Chart of Approved Multiple Myeloma Drugs

 

Classes of Key Multiple Myeloma Drugs As of March 2024

The table provided below can be downloaded and used as a quick reference. Please note this table is a guide to key multiple myeloma therapies, but it is not an exhaustive list. 

 

Download a PDF of This Chart

 

What's Next?

What Is a Clinical Trial?

If resistant to, or intolerant of approved therapies, you may consider clinical trials. 

Learn about renal dysfunction, anemia, bone pain, infections, and other complications.


 


The International Myeloma Foundation medical and editorial content team

Comprised of leading medical researchers, hematologists, oncologists, oncology-certified nurses, medical editors, and medical journalists, our team has extensive knowledge of the multiple myeloma treatment and care landscape. Additionally, Dr. Brian G.M. Durie reviews and approves all medical content on this website. 

Last Medical Content Review: October 22, 2021

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