Integrating novel agents into multiple myeloma treatment - current status in Switzerland and treatment recommendations.
The treatment of multiple myeloma has undergone significant changes in the recent past. The arrival of novel agents, especially thalidomide, bortezomib and lenalidomide, has expanded treatment options and patient outcomes are improving significantly. This article summarises the discussions of an expert meeting which was held to debate current treatment practices for multiple myeloma in Switzerland concerning the role of the novel agents and to provide recommendations for their use in different treatment stages based on currently available clinical data. Novel agent combinations for the treatment of newly diagnosed, as well as relapsed multiple myeloma are examined. In addition, the role of novel agents in patients with cytogenetic abnormalities and renal impairment, as well as the management of the most frequent side effects of the novel agents are discussed. The aim of this article is to assist in treatment decisions in daily clinical practice to achieve the best possible outcome for patients with multiple myeloma.
Taverna
C
C
Medizinische Klinik, Kantonsspital Münsterlingen, 8596 Münsterlingen, CH, Switzerland. christian.taverna@stgag.ch
Bargetzi
M
M
Betticher
D
D
Gmür
J
J
Gregor
M
M
Heim
D
D
Hess
U
U
Ketterer
N
N
Lerch
E
E
Matthes
T
T
Mey
U
U
Pabst
T
T
Renner
C
C
D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001707:Biopsy, Needle; D001853:Bone Marrow / Q000187:drug effects / Q000473:pathology; D016026:Bone Marrow Transplantation; D001897:Boronic Acids / Q000009:adverse effects / Q000627:therapeutic use; D000069286:Bortezomib; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D019008:Drug Resistance, Neoplasm; D019317:Evidence-Based Medicine; D006801:Humans; D000077269:Lenalidomide; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology; D010950:Plasma Cells / Q000187:drug effects / Q000473:pathology; D011719:Pyrazines / Q000009:adverse effects / Q000627:therapeutic use; D019233:Retreatment; D013557:Switzerland; D013792:Thalidomide / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use
D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D013792:Thalidomide; D000069286:Bortezomib; D000077269:Lenalidomide