Novel therapies in the treatment of multiple myeloma.
Multiple myeloma (MM) is a clonal B-cell malignancy characterized by aberrant expansion of plasma cells within bone marrow and extramedullary sites. In 2009, 20,580 new cases of MM and 10,580 deaths from the disease occurred in the United States. Treatment traditionally consists of systemic chemotherapy, with adjunctive use of radiation or surgery in selected cases associated with extramedullary disease. The therapeutic landscape in MM has changed markedly in the past decade with the introduction of the novel immunomodulatory agents thalidomide and lenalidomide, and the first-in-class proteasome inhibitor bortezomib. Although MM remains an incurable malignancy, new approaches to therapy incorporating these agents have produced significantly higher response rates and improved intervals of both progression-free and overall survival in the context of randomized, controlled trials. In aggregate, the use of novel therapies in MM has been associated with substantial improvements in patient outcome.
Laubach
Jacob P
JP
Harvard Medical School and Dana Farber Cancer Institute, Boston, Massachusetts 02115, USA. jacobp_laubach@dfci.harvard.edu
Mitsiades
Constantine S
CS
Mahindra
Anuj
A
Schlossman
Robert L
RL
Hideshima
Teru
T
Chauhan
Dharminder
D
Carreau
Nicole A
NA
Ghobrial
Irene M
IM
Raje
Noopur
N
Munshi
Nikhil C
NC
Anderson
Kenneth C
KC
Richardson
Paul G
PG
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001897:Boronic Acids / Q000627:therapeutic use; D000069286:Bortezomib; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D000077269:Lenalidomide; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000601:surgery; D011719:Pyrazines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013792:Thalidomide / Q000031:analogs & derivatives / Q000627:therapeutic use
D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D013792:Thalidomide; D000069286:Bortezomib; D000077269:Lenalidomide