title: New approaches to management of multiple myeloma.
abstract: Multiple myeloma is still an incurable disease with pattern of regression and remission followed by multiple relapses raising from the residual myeloma cells surviving even in the patients who achieve complete clinical response to treatment. New antimyeloma drugs such as thalidomide, lenalidomide, and bortezomib have dramatically changed treatment paradigm leading to both tumor reduction and tumor suppression. Much progress has been made, but still many unsolved questions remain. In the mode of sequencing treatment for patients with multiple myeloma, we are still using old drugs such as the alkylating agent melphalan, which continues to play a central role in the transplantation setting. Newer drugs are now emerging and are being tested: monoclonal antibodies, histone deacetylase (romidespsin), MLN9708 (ixazomib) a new oral proteasome inhibitor, carfilzomib, signal transduction modulator perifosine. Many advances have been made, but there is still a long way to go.
authors.affiliation: Medical Faculty, University Hematology Clinic, Skopje, Skopje, Macedonia.
authors.forename: Sonja
authors.initials: S
authors.lastname: Genadieva-Stavric
authors.forename: Federica
authors.initials: F
authors.lastname: Cavallo
authors.forename: Antonio
authors.initials: A
authors.lastname: Palumbo
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000145:classification / Q000627:therapeutic use*; D001896:Boron Compounds / Q000627:therapeutic use; D001897:Boronic Acids / Q000627:therapeutic use; D000069286:Bortezomib; D047630:Depsipeptides / Q000627:therapeutic use; D016330:Frail Elderly; D005998:Glycine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D000077269:Lenalidomide; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D009842:Oligopeptides / Q000627:therapeutic use; D010767:Phosphorylcholine / Q000031:analogs & derivatives / Q000627:therapeutic use; D061988:Proteasome Inhibitors / Q000627:therapeutic use; D011719:Pyrazines / Q000627:therapeutic use; D011788:Quality of Life; D012008:Recurrence; D013792:Thalidomide / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D001896:Boron Compounds; D001897:Boronic Acids; D047630:Depsipeptides; D009842:Oligopeptides; D061988:Proteasome Inhibitors; D011719:Pyrazines; D010767:Phosphorylcholine; C105905:perifosine; D013792:Thalidomide; D000069286:Bortezomib; C548400:ixazomib; C524865:carfilzomib; C087123:romidepsin; D000077269:Lenalidomide; D005998:Glycine