title: Initial treatment of transplant-ineligible patients in multiple myeloma.
abstract: Over two-thirds of newly diagnosed multiple myeloma are over 65 years. The treatment goals for the non-transplant-eligible patients should be to prolong survival by achieving the best response, while ensuring quality of life. New upfront treatment combinations based on first generation of novel proteasome inhibitors and immunomodulatory drugs plus alkylating agents, the historical platform, have significantly improved outcomes in the past 10 years. Other non-alkylator induction regimens, essentially lenalidomide plus low-dose dexamethasone are also available and provide a novel backbone that may be combined with novel second- and third-generation drugs. Data indicate that prolonged treatment extends the progression-free survival. In summary, this group requires individualized and dose-modified regimens to improve tolerability and efficacy, while maintaining their quality of life.
authors.affiliation: Hospital Universitario de Salamanca, Paseo San Vicente 58-182, 37007 Salamanca, Spain.
authors.forename: María-Victoria
authors.initials: MV
authors.lastname: Mateos
authors.forename: Xavier
authors.initials: X
authors.lastname: Leleu
authors.forename: Antonio
authors.initials: A
authors.lastname: Palumbo
authors.forename: Jesús-F
authors.initials: JF
authors.lastname: San Miguel
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D002869:Chromosome Aberrations; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D016130:Immunophenotyping; D000077269:Lenalidomide; D009101:Multiple Myeloma / Q000188:drug therapy*; D061988:Proteasome Inhibitors / Q000627:therapeutic use; D011788:Quality of Life; D012074:Remission Induction; D013792:Thalidomide / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D018906:Antineoplastic Agents, Alkylating; D018931:Antineoplastic Agents, Hormonal; D005938:Glucocorticoids; D061988:Proteasome Inhibitors; D013792:Thalidomide; D000077269:Lenalidomide