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Review
. 2013 Sep;4(5):307-21.

Novel agents for the treatment of multiple myeloma: proteasome inhibitors and immunomodulatory agents

Sandra E Kurtin  1 , Elizabeth Bilotti  1
Affiliations
Review

Novel agents for the treatment of multiple myeloma: proteasome inhibitors and immunomodulatory agents

Sandra E Kurtin et al. J Adv Pract Oncol. 2013 Sep.

Abstract

The integration of novel agents into the treatment of multiple myeloma (MM) has shifted the focus from an incurable disease to one that is chronic, with a realistic hope of someday achieving a cure. Proteasome inhibitors and immunomodulatory agents are the backbone of novel therapies for MM. These agents are particularly important for patients with relapsed or refractory disease, a fate faced by the majority of myeloma patients over the course of their disease. Review of recent clinical trial data for the proteasome inhibitors and immunomodulatory agents, including clinical efficacy and safety information, will assist the advanced practitioner in oncology with integrating these data into the current treatment guidelines for MM.

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Figures

Table 1
Table 1
Table 1. NCCN-Recommended Treatment of Newly Diagnosed Transplant-Eligible Multiple Myeloma Patients Based on Selected Clinical Trials
Table 2
Table 2
Table 2. NCCN-Recommended Treatment of Newly Diagnosed Transplant-Ineligible Multiple Myeloma Patients Based on Selected Cinical Trials
Table 3
Table 3
Table 3. NCCN-Recommended Maintenance Therapy Following Stem Cell Transplant or Continuous Treatment in Transplant-Ineligible Patients With Multiple Myeloma
Table 4
Table 4
Table 4. Current FDA-Approved Options for Salvage Treatment in Patients With Relapsed or Refractory Multiple Myeloma Based on Selected Clinical Trials
Figure 1
Figure 1
Figure. 26S proteasome structure. Adapted with permission from Kloetzel (2001).
Table 5
Table 5
Table 5. Mechanism of Action, Dosing, and Route of Administration of Proteasome Inhibitors
Table 6
Table 6
Table 6. Key Clinical Trials for Approval of Proteasome Inhibitors
Table 7
Table 7
Table 7. Mechanism of Action of Thalidomide, Lenalidomide, and Pomalidomide
Table 8
Table 8
Table 8. Clinical Trials of Pomalidomide
Table 9
Table 9
Table 9. Common Adverse Events for Proteasome Inhibitors and Immunomodulatory Agents Used to Treat Multiple Myeloma
Table 10
Table 10
Table 10. Clinical Management of Common Treatment-Emergent Adverse Events Associated With Proteasome Inhibitors and Immunomodulatory Agents Used in the Treatment of Multiple Myeloma
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References

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