Current Developments and Perspectives in Multiple Myeloma

*Michel Delforge,1 Stefan Knop,2 Mohamad Mohty3

1. Department of Hematology, University Hospital Leuven, Leuven, Belgium
2. Schwerpunkt Hämatologie / Onkologie, Medizinische Klinik und Poliklinik II der Universität, Würzburg, Germany
3. Hôpital Saint-Antoine, University UPMC, INSERM, Hematology Department, Paris, France
*Correspondence to michel.delforge@uzleuven.be

Disclosure: M. Delforge received lectures and advisory board honoraria from Celgene and Janssen, whose products are discussed in this manuscript. S. Knop received honoraria from Celgene, ONYX, and Janssen, as well as advisory roles honoraria from Celgene and ONYX and travel support from Celgene. M. Mohty received research support and lectures honoraria from Amgen, Celgene, Janssen, and Sanofi, whose products are discussed in this manuscript. Support: The authors would like to thank Dr Caroline Charles for medical writing assistance with this manuscript.
Received: 20.05.14 Accepted: 16.06.14
Citation: EMJ Hema. 2014;1:88-98.

Abstract

In the last decades, advances in the therapeutic management of multiple myeloma (MM) with new drug armamentarium and strategies have significantly improved the outcome and survival of newly diagnosed and relapsed patients. However, the continuing challenges physicians are facing within specific clinical settings and patient subpopulations, whose prognosis with current strategies is extremely poor, call for a paradigm change. New immunomodulators, proteasome inhibitors, histone deacetylase inhibitors, and monoclonal antibodies are being explored to improve first-line outcomes so that a smaller proportion of patients relapse early or fail to respond to induction treatment. Moreover, recent advances and clinical evidence with novel therapies seem to provide patients with relapsed or refractory MM additional survival benefits. Improving clinical outcomes and refining standard of care should help clinicians reduce the burden of multiple and toxic therapy; quality of life (QoL) should be at the core of MM management. Patient selection and stratification needs to be reinforced with the help of comprehensive knowledge on conventional risk factors, and supplemented by molecular pathways in the near future in order to provide tailored options and strategies to patients, including the use of monoclonal antibodies. Numerous drugs are on the horizon and the next few years should witness marked improvements in survival, QoL, and safety of MM management.

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