New drugs for multiple myeloma

Abstract

Multiple myeloma is a plasma cell neoplasm that is currently incurable. Older patients are managed with melphalan and prednisolone. Younger patients have induction chemotherapy followed by high-dose melphalan and autologous stem cell transplantation. Recent insights into the biological basis of myeloma have resulted in several new drugs becoming available. Thalidomide, bortezomib and lenalidomide have each improved the response to therapy, but they are expensive. Future challenges include optimising the sequence of these drugs, refining their combination with standard drugs and high-dose therapy, and identifying the subgroups of patients most likely to benefit from them.