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The emerging role of novel therapeutic agents in the management of patients with multiple myeloma
Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
Increased understanding of the pathogenesis and biology of multiple myeloma (MM) has led to the successful development of novel therapeutic agents that specifically target abnormal signaling pathways and tumor/microenvironmental interactions in this disease. The rapid translation of informative laboratory data to successful clinical trials has contributed to regulatory approval of three novel therapeutic agents in MM (bortezomib, thalidomide, and lenalidomide), reflecting MM’s emergence as a disease model for the development of effective new therapeutic agents that target both tumor and its microenvironment. In this review, we update the evaluation of patients with MM, describe advances in staging, and discuss newly discovered prognostic factors that correlate with poor survival. In addition, we summarize the current understanding of clinical trials in patients with newly diagnosed and relapsed/refractory MM, as well as the therapeutic options for patients who are and who are not candidates for stem-cell transplantation. A key challenge in future clinical trials is to define combinations that target specific abnormalities in patients with MM, based on the molecular profile of their disease, to overcome drug resistance and improve outcomes in this otherwise fatal disease.
| Commun Oncol 2006;3:575–582 | full text |  165 kb |