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Review
. 2012;17(5):592-606.
doi: 10.1634/theoncologist.2011-0391. Epub 2012 May 9.

European perspective on multiple myeloma treatment strategies: update following recent congresses

Heinz Ludwig  1 , Hervé Avet-Loiseau, Joan Bladé, Mario Boccadoro, Jamie Cavenagh, Michele Cavo, Faith Davies, Javier de la Rubia, Sosana Delimpasi, Meletios Dimopoulos, Johannes Drach, Hermann Einsele, Thierry Facon, Hartmut Goldschmidt, Urs Hess, Ulf-Henrik Mellqvist, Philippe Moreau, Jesús San-Miguel, Pia Sondergeld, Pieter Sonneveld, Miklos Udvardy, Antonio Palumbo
Affiliations
Review

European perspective on multiple myeloma treatment strategies: update following recent congresses

Heinz Ludwig et al. Oncologist. 2012.

Erratum in

  • Oncologist. 2012;17(7):1005

Abstract

The management of multiple myeloma has undergone profound changes over the recent past as a result of advances in our understanding of the disease biology as well as improvements in treatment and supportive care strategies. Notably, recent years have seen a surge in studies incorporating the novel agents thalidomide, bortezomib, and lenalidomide into treatment for different disease stages and across different patient groups. This article presents an update to a previous review of European treatment practices and is based on discussions during an expert meeting that was convened to review novel agent data published or presented at medical meetings until the end of 2011 and to assess their impact on treatment strategies.

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Conflict of interest statement

Disclosures: Heinz Ludwig: Mundipharma, Celgene, Janssen (RF, H); Hervé Avet-Loiseau: Janssen (C/A); Joan Bladé: Janssen, Celgene, Merck, Onyx (C/A); Janssen, Spain (RF); Mario Boccadoro: Celgene, Janssen(H); Faith Davies: Johnson and Johnson, Celgene (C/A); Johnson and Johnson, Celgene, Novartis (H); Javier de la Rubia: Janssen (C/A); Speakers bureau (H); Meletios Dimopoulos: Celgene, Ortho-Biotech (H); Johannes Drach: Jannsen, Celgene, Mundipharma (H); Hermann Einsele: Novartis, Celgene, Janssen Cilag (H, RF); Thierry Facon: Janssen, Celgene (C/A); Hartmut Goldschmidt: Celgene, Janssen (C/A); Celgene, Janssen, Novartis (RF); Urs Hess: Janssen, Celgene (C/A); Ulf-Henrik Mellqvist: Janssen, Celgene, Mundipharma, Novartis (H); Philippe Moreau: Celgene, Janssen, Millennium (C/A); Celgene, Janssen (H); Jesús San-Miguel: Janssen, Celgene, Millennium (C/A); Pia Sondergeld: Other: Medical writing services: Janssen; Pieter Sonneveld: Janssen, Celgene, Onyx, Novartis (C/A); Janssen, Celgene, Onyx (RF); Antonio Palumbo: Celgene, Janssen Cilag (C/A); Celgene, Janssen Cilag, Amgen, Merck (H). The other authors indicated no financial relationships.

Figures

Figure 1.
Figure 1.
Multiple myeloma treatment tree outside clinical trials: frontline†. *Data available from phase III randomized trial. Abbreviations: CTDa, attenuated cyclophosphamide, thalidomide, and dexamethasone; EMA, European Medicines Agency; Dex, dexamethasone; IMiD, immunomodulatory drug; MPR-R, melphalan, prednisone, and lenalidomide plus lenalidomide maintenance; MPT, melphalan, prednisone, and thalidomide; RD, lenalidomide and high-dose dexamethasone; Rd, lenalidomide and low-dose dexamethasone; RVD, lenalidomide, bortezomib, and dexamethasone; VMP, bortezomib, melphalan, and prednisone; VMPT, VMP plus thalidomide; VP, bortezomib plus prednisone; VT, bortezomib plus thalidomide; VTD, bortezomib, thalidomide, and dexamethasone.
Figure 2.
Figure 2.
Multiple myeloma treatment tree outside clinical trials: first relapse. *Data available from phase III randomized trial. Abbreviations: ASCT, allogeneic stem cell transplantation; autoSCT, autologous stem cell transplantation; CRD, cyclophosphamide, lenalidomide, and dexamethasone; Dex, dexamethasone; CTD, cyclophosphamide, thalidomide, and dexamethasone; IMiD, immunomodulatory drug; Len, lenalidomide; MPT, melphalan, prednisone, and thalidomide; PLD, pegylated liposomal doxorubicin; RD, lenalidomide and high-dose dexamethasone; Rd, lenalidomide and low-dose dexamethasone; TFI, treatment-free interval; Thal, thalidomide; VCD, bortezomib, cyclophosphamide, and dexamethasone; VD, bortezomib plus dexamethasone; VMP, bortezomib, melphalan, and prednisone; VMPT, VMP plus thalidomide; VTD, bortezomib, thalidomide, and dexamethasone.
See this image and copyright information in PMC

References

    1. Facon T, Mary JY, Hulin C, et al. Melphalan and prednisone plus thalidomide versus melphalan and prednisone alone or reduced-intensity autologous stem cell transplantation in elderly patients with multiple myeloma (IFM 99–06): A randomised trial. Lancet. 2007;370:1209–1218. - PubMed
    1. Kumar SK, Rajkumar SV, Dispenzieri A, et al. Improved survival in multiple myeloma and the impact of novel therapies. Blood. 2008;111:2516–2520. - PMC - PubMed
    1. Hulin C, Facon T, Rodon P, et al. Efficacy of melphalan and prednisone plus thalidomide in patients older than 75 years with newly diagnosed multiple myeloma: IFM 01/01 trial. J Clin Oncol. 2009;27:3664–3670. - PubMed
    1. San Miguel JF, Schlag R, Khuageva NK, et al. Bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma. N Engl J Med. 2008;359:906–917. - PubMed
    1. San Miguel JF, Schlag R, Khuageva NK, et al. Continued overall survival benefit after 5 years' follow-up with bortezomib-melphalan-prednisone (VMP) versus melphalan-prednisone (MP) in patients with previously untreated multiple myeloma, and no increased risk of second primary malignancies: Final results of the phase 3 VISTA trial [abstract 476] Blood. 2011;118:476. - PubMed

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