Resumen
Advances in our understanding of the causes of multiple myeloma and the mechanisms of disease progression have facilitated significant changes in the way we treat this incurable blood cancer. This review summarizes the genetic changes critical in disease development, the dysregulation of the immune system and how cells of the tumour microenvironment interact with and promote the survival of malignant plasma cells. We then provide a comprehensive overview of recent practice changing clinical trials incorporating novel agents into upfront treatment regimens as well as explore innovative immunotherapies, designed to overcome the dysfunctional immune system, and small molecules with novel mechanisms of action that are currently actively investigated in the relapsed and/or refractory disease setting.