Service des maladies du sang, hôpital Huriez, CHRU, Lille, Bing center for Waldenstrom Macroglobulinemia and Jerome Lipper Multiple Myeloma center, Medical oncology, Dana-Farber Cancer Institute and Harvard Medical School, 44 Binney Street, Boston, MA 02115, USA
- Key words: multiple myeloma, bortezomib, new indications
- Page(s) : 67-76
- Published in: 2006
Multiple myeloma (MM) is a malignant hemopathy characterised by the bone marrow involvement by clonal plasma cells. MM is the second most common hematologic malignancy and remains incurable with standard chemotherapeutic agents. While high-dose therapy with stem cell transplantation (ASCT) remains one of the options to improve survival in transplant candidates, however, long-term disease free survival is uncommon. Moreover, MM occurs more frequently in elderly patients (median age 71 years) and significant number of patients has poor performance status or co-morbidities and is not transplant candidates. The conventional-dose therapies in this patient population achieve less than 50% response rates and median OS between 3 and 4 years. In that context, the development of new molecules, such as thalidomide or its analogues (lenalidomide) and the first proteasome inhibitor, bortezomib, has recently improved the management of this hemopathy. Herein, we will review new strategies in MM, including updated development in ASCT and the role of innovative molecules in the management of this pathology. However, the majority of the patients are older and therapeutics must be adapted to this particular subgroup of patients.