title: Managing multiple myeloma: the emerging role of novel therapies and adapting combination treatment for higher risk settings.
abstract: Novel therapies have transformed the treatment paradigm for multiple myeloma with significant improvements in survival now seen in both younger and older patients. Nonetheless, the disease is heterogeneous and high-risk patients in particular continue to have poor outcome. Moreover, the disease remains incurable. Efforts to refine risk stratification and disease characteristics continue with the use of cytogenetics, enhanced imaging techniques and other new technologies, such as genomics. The integration of novel therapies into induction therapy, consolidation and maintenance continues to evolve, and the appropriate use of combination strategies including proteasome inhibition and immunomodulatory treatment is emerging as a platform with application across the disease spectrum. Despite these advances, resistance to novel agents occurs and so the identification of new targets and the recognition of clonal heterogeneity are especially important as improvements to current treatment strategies are developed, with the goal of further improving patient outcome.
authors: Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School Boston, Boston, MA, USA.
authors: Paul G
authors: PG
authors: Richardson
authors: Jacob
authors: J
authors: Laubach
authors: Constantine S
authors: CS
authors: Mitsiades
authors: Robert
authors: R
authors: Schlossman
authors: Teru
authors: T
authors: Hideshima
authors: Katherine
authors: K
authors: Redman
authors: Dharminder
authors: D
authors: Chauhan
authors: Irene M
authors: IM
authors: Ghobrial
authors: Nikhil
authors: N
authors: Munshi
authors: Kenneth C
authors: KC
authors: Anderson
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002869:Chromosome Aberrations; D006801:Humans; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000235:genetics; D011379:Prognosis; D016896:Treatment Outcome