Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Haematological cancer

Where are we now with the treatment of multiple myeloma?

The current standard-of-care therapy for patients with multiple myeloma is autologous stem-cell transplantation; however, whether this approach should be enhanced or displaced by triplet combination therapy is the subject of ongoing debate. We discuss the latest trial that has attempted to address this question and the impact of transplantation and triplet therapy assessment and surrogate end points in future trial design.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Davies, F. E. et al. Thalidomide and immunomodulatory derivatives augment natural killer cell cytotoxicity in multiple myeloma. Blood 98, 210–216 (2001).

    Article  CAS  Google Scholar 

  2. Richardson, P. G. et al. Bortezomib or high-dose dexamethasone for relapsed multiple myeloma. N. Engl. J. Med. 352, 2487–2498 (2005).

    Article  CAS  Google Scholar 

  3. Dimopoulos, M. et al. Lenalidomide plus dexamethasone for relapsed or refractory multiple myeloma. N. Engl. J. Med. 357, 2123–2132 (2007).

    Article  CAS  Google Scholar 

  4. Palumbo, A. et al. Continuous lenalidomide treatment for newly diagnosed multiple myeloma. N. Engl. J. Med. 366, 1759–1769 (2012).

    Article  CAS  Google Scholar 

  5. San Miguel, J. F. et al. Bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma. N. Engl. J. Med. 359, 906–917 (2008).

    Article  CAS  Google Scholar 

  6. Benboubker, L. et al. Lenalidomide and dexamethasone in transplant-ineligible patients with myeloma. N. Engl. J. Med. 371, 906–917 (2014).

    Article  CAS  Google Scholar 

  7. Richardson, P. G. et al. A phase 2 trial of lenalidomide, bortezomib, and dexamethasone in patients with relapsed and relapsed/refractory myeloma. Blood 123, 1461–1469 (2014).

    Article  CAS  Google Scholar 

  8. Roussel, M. et al. Front-line transplantation program with lenalidomide, bortezomib, and dexamethasone combination as induction and consolidation followed by lenalidomide maintenance in patients with multiple myeloma: a phase II study by the Intergroupe Francophone du Myelome. J. Clin. Oncol. 32, 2712–2717 (2014).

    Article  CAS  Google Scholar 

  9. Durie, B. G. et al. Bortezomib with lenalidomide and dexamethasone versus lenalidomide and dexamethasone alone in patients with newly diagnosed myeloma without intent for immediate autologous stem-cell transplant (SWOG S0777): a randomised, open-label, phase 3 trial. Lancet 389, 519–527 (2017).

    Article  CAS  Google Scholar 

  10. Attal, M. et al. Lenalidomide, bortezomib, and dexamethasone with transplantation for myeloma. N. Engl. J. Med. 376, 1311–1320 (2017).

    Article  CAS  Google Scholar 

  11. Gay, F. et al. Chemotherapy plus lenalidomide versus autologous transplantation, followed by lenalidomide plus prednisone versus lenalidomide maintenance, in patients with multiple myeloma: a randomised, multicentre, phase 3 trial. Lancet Oncol. 16, 1617–1629 (2015).

    Article  CAS  Google Scholar 

  12. Cavo, M. et al. Upfront single versus double autologous stem cell transplantation for newly diagnosed multiple myeloma: an Intergroup, multicenter, phase III study of the European Myeloma Network (EMN02/HO95 MM trial). Blood 128, a991 (2016).

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gareth J. Morgan.

Ethics declarations

Competing interests

G.J.M. declares he has received consultancy (speaker fees) and honoraria from Celgene, Janssen and Takeda, but has no patents, stocks and/or ownerships. L.R. declares no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Morgan, G., Rasche, L. Where are we now with the treatment of multiple myeloma?. Nat Rev Clin Oncol 14, 461–462 (2017). https://doi.org/10.1038/nrclinonc.2017.82

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrclinonc.2017.82

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing