Newer therapeutic molecules for multiple myeloma.

ABSTRACT

Therapeutic management of multiple myeloma (MM) for the last several decades has mainly involved regimens based on use of glucocorticoids and cytotoxic chemotherapeutics. Despite progress in delineating the activity of such regimens, at either conventional or high doses, MM has remained an incurable disease. This has sparked major interest in the development of novel therapies that in part capitalize on recent advances in our understanding of the biology of MM, including the molecular mechanisms by which MM cell-host bone marrow (BM) interactions regulate tumor-cell growth, survival, and drug resistance in the BM milieu. Herein, we review the latest progress in the development of these novel anti-MM therapies, with major focus on therapies which have translated from preclinical evaluation to clinical application, including thalidomide and its more potent immunomodulatory derivatives (IMiD), the first-in-class proteasome inhibitor bortezomib (formerly known as PS-341). Search strategy included Medline using the terms 'Myeloma and Newer Drugs' citations relevant to treatment guidelines issued in 1999 and 2008 were screened.