Management of multiple myeloma in the era of novel drugs

摘要

Multiple Myeloma (MM) is a malignancy of terminally differentiatedplasma cells and is the second most common hematologicalneoplasm to Non-Hodgkin’s Lymphoma. Generally,it is disease of older patients. Our knowledge about theunderlying biological and cytogenetic abnormalities leadingto MM is rapidly increasing. Similarly our ability is improvingto treat this complex disease. A number of new treatmentshave been introduced into our armamentarium in the past10-15 years. Until recently, high rates of complete responses(CR) and other major responses were seen only in patientsundergoing treatment with high dose chemotherapy with autologousstem cell support (HD+ASCT). However new regimens,incorporating new agents (thalidomide, lenalidomide,bortezomib) are now offering similar response rates and lowertoxicity than HD+ASCT. The new agents seem to combinewell with classical chemotherapy agents (melphalan, cyclophosphamide),modern chemotherapy (pegylated liposomaldoxorubicin) and steroids (dexamethasone, prednisone).In addition, the novel agents show significant activity whencombined with each other in patients with newly diagnosedas well as relapsed/refractory MM patients. Although this isstill considered an incurable disease, the life expectancy andquality of life of MM patients is continuously improving. Ourhope is that progress in this area of research will continuewith the advent of new treatment options and will lead to theultimate goal: a cure.