@article{3102710, title = "Treatment of relapsed and refractory multiple myeloma: recommendations from the International Myeloma Working Group", author = "Moreau, P. and Kumar, S.K. and San Miguel, J. and Davies, F. and Zamagni, E. and Bahlis, N. and Ludwig, H. and Mikhael, J. and Terpos, E. and Schjesvold, F. and Martin, T. and Yong, K. and Durie, B.G.M. and Facon, T. and Jurczyszyn, A. and Sidana, S. and Raje, N. and van de Donk, N. and Lonial, S. and Cavo, M. and Kristinsson, S.Y. and Lentzsch, S. and Hajek, R. and Anderson, K.C. and João, C. and Einsele, H. and Sonneveld, P. and Engelhardt, M. and Fonseca, R. and Vangsted, A. and Weisel, K. and Baz, R. and Hungria, V. and Berdeja, J.G. and Leal da Costa, F. and Maiolino, A. and Waage, A. and Vesole, D.H. and Ocio, E.M. and Quach, H. and Driessen, C. and Bladé, J. and Leleu, X. and Riva, E. and Bergsagel, P.L. and Hou, J. and Chng, W.J. and Mellqvist, U.-H. and Dytfeld, D. and Harousseau, J.-L. and Goldschmidt, H. and Laubach, J. and Munshi, N.C. and Gay, F. and Beksac, M. and Costa, L.J. and Kaiser, M. and Hari, P. and Boccadoro, M. and Usmani, S.Z. and Zweegman, S. and Holstein, S. and Sezer, O. and Harrison, S. and Nahi, H. and Cook, G. and Mateos, M.-V. and Rajkumar, S.V. and Dimopoulos, M.A. and Richardson, P.G.", journal = "The lancet oncology", year = "2021", volume = "22", number = "3", pages = "e105-e118", publisher = "The Lancet Publishing Group", doi = "10.1016/S1470-2045(20)30756-7", keywords = "bortezomib; carfilzomib; daratumumab; dexamethasone; doxorubicin; elotuzumab; idecabtagene vicleucel; isatuximab; lenalidomide; melphalan; panobinostat; pomalidomide; prednisone; antineoplastic agent, cancer recurrence; cancer survival; clinical practice; drug efficacy; drug safety; fatigue; gastrointestinal disease; health care policy; high income country; human; intention to treat analysis; low income country; middle income country; minimal residual disease; multiple myeloma; overall survival; practice guideline; progression free survival; refractory multiple myeloma; Review; systematic review; thrombocytopenia; drug effect; drug resistance; multiple myeloma; pathology; salvage therapy; tumor recurrence, Antineoplastic Agents; Drug Resistance, Neoplasm; Humans; Multiple Myeloma; Neoplasm Recurrence, Local; Practice Guidelines as Topic; Salvage Therapy", abstract = "This Policy Review presents the International Myeloma Working Group's clinical practice recommendations for the treatment of relapsed and refractory multiple myeloma. Based on the results of phase 2 and phase 3 trials, these recommendations are proposed for the treatment of patients with relapsed and refractory disease who have received one previous line of therapy, and for patients with relapsed and refractory multiple myeloma who have received two or more previous lines of therapy. These recommendations integrate the issue of drug access in both low-income and middle-income countries and in high-income countries to help guide real-world practice and thus improve patient outcomes. © 2021 Elsevier Ltd" }