Multiple myeloma: is a shift toward continuous therapy needed to move forward?

Abstract

Multiple myeloma (MM) accounts for 1% of all cancers and 13% of all hematologic malignancies. Melphalan–prednisone plus melphalan–prednisone–thalidomide or melphalan–prednisone–bortezomib are considered the standards of care for newly diagnosed, transplant-ineligible patients with MM (older than 65 years). In newly diagnosed, transplant-eligible patients with MM (younger than 65 years), a novel agent-based induction followed by high-dose therapy and autologous stem cell transplantation, is the standard approach. The availability of novel agents has considerably increased the treatment options of this disease, but almost all patients relapse after achieving a maximal response to first-line therapy. New drugs and new treatment approaches are urgently needed to improve outcome in MM patients Continuous therapy can be a valid option to keep the patient symptom-free and to prolong progression-free survival and overall survival.

Keywords:

• bortezomib
• continuous therapy
• lenalidomide
• maintenance
• multiple myeloma
• thalidomide

Acknowledgements

The authors would like to thank the assistant G Schirripa for his support in the preparation of the manuscript.

Financial & competing interest disclosure

T Guglielmelli has received research funding from Celgene. A Palumbo has received honoraria from Amgen, Bristol-Myers Squibb, Genmab A/S, Celgene, Janssen-Cilag, Millennium Pharmaceuticals Inc., Onyx Pharmaceuticals, Array BioPharma and Sanofi Aventis and consultancy fees from Amgen, Bristol-Myers Squibb, Genmab A/S, Celgene, Janssen-Cilag, Millennium Pharmaceuticals Inc., Onyx Pharmaceuticals. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.