How I treat high-risk myeloma.
The treatment of patients with myeloma has dramatically changed over the past decade due in part to the development of new agents and myeloma-specific targets. Despite these advancements, a group for whom the long-term benefit remains less clear are patients with genetically or clinically defined high-risk myeloma. In order to successfully treat these patients, it is important to first identify these patients, treat them with aggressive combination therapy, and employ the use of aggressive long-term maintenance therapy. Future directions include the use of new immune-based treatments (antibodies or cellular-based therapies) as well as target-driven approaches. Until these treatment approaches are better defined, this review will provide a potential treatment approach for standard- and high-risk myeloma that can be followed using agents and strategies that are currently available with the goal of improving progression-free and overall survival for these patients today.
Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA.
Sagar
S
Lonial
Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA.
Lawrence H
LH
Boise
Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA.
Jonathan
J
Kaufman
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000069286:Bortezomib / Q000627:therapeutic use; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D000077269:Lenalidomide; D009101:Multiple Myeloma / Q000188:drug therapy / Q000473:pathology* / Q000628:therapy*; D009842:Oligopeptides / Q000627:therapeutic use; D061988:Proteasome Inhibitors / Q000627:therapeutic use; D013792:Thalidomide / Q000031:analogs & derivatives / Q000627:therapeutic use
D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D009842:Oligopeptides; D061988:Proteasome Inhibitors; D013792:Thalidomide; D000069286:Bortezomib; C524865:carfilzomib; C467566:pomalidomide; D000077269:Lenalidomide