Treatment for multiple myeloma: pharmacoeconomic aspects

To date, the choice of treatment policy for patients with multiple myeloma (MM) is based primarily on factors, such as age and concomitant diseases. The widespread use and clinical application of cytogenetic techniques (karyotyping and fluorescence in situ hybridization (FISH)) has made it possible to identify and use cytogenetic abnormalities as prognostic biomarkers to assess key parameters, such as progression-free survival (PFS) and overall survival (OS), in patients with MM. Chromosomal abnormalities enable the identification of patients with a poor prognosis (high-risk myeloma) who have the lowest prognostic survival. Despite the clarification of the main mutations that cause a poor prognosis for survival in patients with myeloma, the question of choosing the most optimal therapy regimen to increase survival is still relevant. However, the optimal treatment has not been developed for patients with MM with high-risk cytogenetics at the time of diagnosis. With allowance made for the steadily increasing costs of managing MM patients, there is a need for their optimization just at the stage of choosing first-line therapy. The FISH assay may serve as the most rational approach to identifyng high-risk chromosomal abnormalities and to prescribing triplet therapy with new agents for these patients. The review provides brief information about the main chromosomal rearrangements occurring in MM ad their prognostic value and considers the pharmacoeconomic aspects of the treatment of patients with myeloma.

multiple myeloma, cytogenetic abnormalities, pharmacoeconomics, first-line therapy