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Conclusion: advances in current treatment for patients with newly diagnosed multiple myeloma

Leukemia Supplements volume 2, pages S28–S29 (2013)Cite this article

In recent years, the availability of the novel agents thalidomide, lenalidomide and bortezomib has greatly expanded the treatment options available for the management of patients with newly diagnosed multiple myeloma (NDMM). The articles in this supplement provide an overview of the current approaches to the management of NDMM patients and highlight some of the key research issues that still remain to be answered. The themes regarding the optimal approach to treatment and the role of novel therapies, which emerge from these studies, are summarized below.

An ever increasing number of new induction regimens based on thalidomide, lenalidomide and bortezomib (or combinations of these agents with steroids and alkylating agents) have demonstrated substantial improvements in efficacy and tolerability.1, 2, 3, 4, 5, 6 The high-quality, durable responses associated with bortezomib- or lenalidomide-containing induction regimens are such that some patients may be able to delay the need for autologous stem cell transplantation (ASCT), changing the frontline treatment strategy for NDMM. This approach is being tested in the context of phase III studies with mixed results; thus, it is premature to presume that the high overall response rates seen with new combinations will eliminate the need for ASCT for suitable patients. Currently, all patients who are eligible should be referred to a transplantation center early in their disease course to discuss the timing and collection of stem cell grafts. The role of allogeneic stem cell transplantation remains controversial, with limited use among a majority of patients at this time. Its use is being explored within the setting of clinical trials, but its role in routine care is currently very limited.

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Acknowledgements

I thank Shanthi Jayawardena, PhD, and Eva Polk, PhD (Excerpta Medica), for the linguistic improvement of the manuscript. Editorial support in the preparation of this manuscript was funded by Celgene Corporation. SL is supported by the Richard and Annelly Deets Fund for Multiple Myeloma. SL was fully responsible for all content and editorial decisions for this manuscript.

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  1. Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA

    S Lonial

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Correspondence to S Lonial.

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SL has had a consultant role for Millennium, Celgene Corporation, Novartis, Merck, Bristol Myers Squibb, Onyx and Johnson and Johnson, with honoraria.

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Lonial, S. Conclusion: advances in current treatment for patients with newly diagnosed multiple myeloma. Leukemia Suppl 2 (Suppl 1), S28–S29 (2013). https://doi.org/10.1038/leusup.2013.6

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