title: The treatment of multiple myeloma patients not eligible for asct.
abstract: Advances in therapies for younger patients with multiple myeloma have resulted in significant improvements in outcome over recent years, on the contrary the progress in treatments for elderly patients has remained more modest. Traditionally, patients who are not eligible for transplantation, like the older patients, have been treated with the combination of melphalan plus prednisone (MP), which leads to responses in approximately 50% of patients; however, patients rarely achieve a complete response (CR) and long-term outcomes are disappointing, with a relapse-free survival of approximately 18 months and an overall survival (OS) of approximately 3 years.With the arrival of novel agents, including the first-in-class proteasome inhibitor, bortezomib, and the immunomodulatory agents, thalidomide and lenalidomide, a shift in the management of older patients and/or those not eligible for transplantation has taken place. Increasingly, novel agents are now being incorporated into therapy, based on the positive findings from clinical trials in this setting, and outcomes have improved accordingly.
authors.affiliation: Jerome Lipper Multiple Myeloma CenterDana-Farber Cancer Institute and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Paul
authors.initials: P
authors.lastname: Richardson
authors.forename: Jacob
authors.initials: J
authors.lastname: Laubach
authors.forename: Anuj
authors.initials: A
authors.lastname: Mahindra
authors.forename: Constantine
authors.initials: C
authors.lastname: Mitsiades
authors.forename: Robert
authors.initials: R
authors.lastname: Schlossman
authors.forename: Irene
authors.initials: I
authors.lastname: Ghobrial
authors.forename: Teru
authors.initials: T
authors.lastname: Hideshima
authors.forename: Noopur
authors.initials: N
authors.lastname: Raje
authors.forename: Nikhil
authors.initials: N
authors.lastname: Munshi
authors.forename: Kenneth
authors.initials: K
authors.lastname: Anderson