From the guest editor: the evolving treatment paradigm in multiple myeloma.

摘要

Thalidomide, lenalidomide, bortezomib, and doxil represent 4 novel drugs that provide the framework for 6 FDA/EMEA new drug registrations for treatment of multiple myeloma (MM) in the past 5 years. As a direct consequence, survival of patients with MM has doubled from 3 to 4 years to 7 to 8 years, and several promising novel agents, alone and in combination, offer even greater promise. The rapid evolution of bench to bedside translational research in MM highlights the need for this up to date description of cutting-edge advances in diagnosis, prognosis, and treatment of MM. Drs. San Miguel, Mateos, and Gutierrez first discuss conventional and cutting-edge genetically based stratification of standard- versus high-risk groups. Excitingly, novel therapies can overcome features associated with adverse prognosis to conventional therapies, highlighting the need to prospectively define risk groups in the era of novel treatments using technologies including genomics and multiparameter fluorescent analysis. Drs. Nooka, Kaufman, and Lonial next describe the accepted definition of complete response (CR), which is critical for comparison of outcome of novel versus conventional treatments. This definition of CR has become more stringent with time, because use of high-dose therapies and integration of novel therapies can for the first time achieve sustained CRs in a significant fraction of patients.