title: Multiple myeloma: from front-line to relapsed therapies.
abstract: Recent developments in the treatment of multiple myeloma (MM) have led to improvements in response rates and to increased survival. A major advance in the last decade has been the introduction of the novel agents thalidomide, bortezomib, and lenalidomide as part of front-line treatment in both the transplant and nontransplant settings. However, disease relapse is inevitable for the majority of patients and myeloma typically recurs more aggressively with each relapse, eventually leading to the development of treatment-refractory disease. Several phase II and III trials have demonstrated the efficacy of recently approved agents in the setting of relapsed and relapsed and refractory MM, including pomalidomide and carfilzomib. Ixazomib, an oral proteasome inhibitor, and multiple other novel classes of agents are being investigated. These include monoclonal antibodies and histone deacetylase inhibitors, which may further add to the therapeutic armamentarium for this malignancy. Therefore, in a disease characterized by multiple relapses, the optimal sequencing of the different effective options is an important consideration in attempting to prolong survival.
authors.affiliation: From the Department of Hematology, University Hospital Hôtel-Dieu, Nantes, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Moreau
authors.affiliation: From the Department of Hematology, University Hospital Hôtel-Dieu, Nantes, France.
authors.forename: Cyrille
authors.initials: C
authors.lastname: Touzeau
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D019008:Drug Resistance, Neoplasm; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage; D009101:Multiple Myeloma / Q000628:therapy*; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D009842:Oligopeptides / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D016879:Salvage Therapy / Q000379:methods; D033581:Stem Cell Transplantation / Q000379:methods; D013792:Thalidomide / Q000031:analogs & derivatives / Q000627:therapeutic use; D014182:Transplantation, Autologous / Q000379:methods; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D009842:Oligopeptides; D013792:Thalidomide; D014750:Vincristine; C524865:carfilzomib; C467566:pomalidomide; D002945:Cisplatin; D008727:Methotrexate