title: Current multiple myeloma treatment strategies with novel agents: a European perspective.
abstract: The treatment of multiple myeloma (MM) has undergone significant developments in recent years. The availability of the novel agents thalidomide, bortezomib, and lenalidomide has expanded treatment options and has improved the outcome of patients with MM. Following the introduction of these agents in the relapsed/refractory setting, they are also undergoing investigation in the initial treatment of MM. A number of phase III trials have demonstrated the efficacy of novel agent combinations in the transplant and nontransplant settings, and based on these results standard induction regimens are being challenged and replaced. In the transplant setting, a number of newer induction regimens are now available that have been shown to be superior to the vincristine, doxorubicin, and dexamethasone regimen. Similarly, in the front-line treatment of patients not eligible for transplantation, regimens incorporating novel agents have been found to be superior to the traditional melphalan plus prednisone regimen. Importantly, some of the novel agents appear to be active in patients with high-risk disease, such as adverse cytogenetic features, and certain comorbidities, such as renal impairment. This review presents an overview of the most recent data with these novel agents and summarizes European treatment practices incorporating the novel agents.
authors.affiliation: Department of Medicine, Wilhelminenspital, Montleartstr. 37, 1160 Vienna, Austria. heinz.ludwig@wienkav.at
authors.forename: Heinz
authors.initials: H
authors.lastname: Ludwig
authors.forename: Meral
authors.initials: M
authors.lastname: Beksac
authors.forename: Joan
authors.initials: J
authors.lastname: Bladé
authors.forename: Mario
authors.initials: M
authors.lastname: Boccadoro
authors.forename: Jamie
authors.initials: J
authors.lastname: Cavenagh
authors.forename: Michele
authors.initials: M
authors.lastname: Cavo
authors.forename: Meletios
authors.initials: M
authors.lastname: Dimopoulos
authors.forename: Johannes
authors.initials: J
authors.lastname: Drach
authors.forename: Hermann
authors.initials: H
authors.lastname: Einsele
authors.forename: Thierry
authors.initials: T
authors.lastname: Facon
authors.forename: Hartmut
authors.initials: H
authors.lastname: Goldschmidt
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Harousseau
authors.forename: Urs
authors.initials: U
authors.lastname: Hess
authors.forename: Nicolas
authors.initials: N
authors.lastname: Ketterer
authors.forename: Martin
authors.initials: M
authors.lastname: Kropff
authors.forename: Larisa
authors.initials: L
authors.lastname: Mendeleeva
authors.forename: Gareth
authors.initials: G
authors.lastname: Morgan
authors.forename: Antonio
authors.initials: A
authors.lastname: Palumbo
authors.forename: Torben
authors.initials: T
authors.lastname: Plesner
authors.forename: Jesús
authors.initials: J
authors.lastname: San Miguel
authors.forename: Ofer
authors.initials: O
authors.lastname: Shpilberg
authors.forename: Pia
authors.initials: P
authors.lastname: Sondergeld
authors.forename: Pieter
authors.initials: P
authors.lastname: Sonneveld
authors.forename: Sonja
authors.initials: S
authors.lastname: Zweegman
mesh_terms: D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols; D001897:Boronic Acids / Q000494:pharmacology / Q000627:therapeutic use*; D000069286:Bortezomib; D002869:Chromosome Aberrations; D002986:Clinical Trials as Topic; D003657:Decision Making; D003663:Decision Trees; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000209:etiology; D000077269:Lenalidomide; D009101:Multiple Myeloma / Q000235:genetics / Q000401:mortality / Q000628:therapy*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D011719:Pyrazines / Q000494:pharmacology / Q000627:therapeutic use*; D033581:Stem Cell Transplantation; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use*; D014184:Transplantation, Homologous
chemical_list: D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D013792:Thalidomide; D000069286:Bortezomib; D000077269:Lenalidomide