Undergoing upfront autologous stem cell transplantation is still the preferred treatment of choice for patients aged 65 or younger with newly diagnosed multiple myeloma, according to interim results of a phase III trial.
In this article, we elucidate the rationale for use of novel drug combinations in patients with myeloma, and review current evidence-based data supporting the use of specific combinations in various settings. We also attempt to craft a framework to guide clinicians in optimizing the use of combination therapies, to enable patients to derive maximal benefit.
Adding ixazomib to the combination of lenalidomide/dexamethasone resulted in a more than 35% improvement in the risk for disease progression or death in patients with relapsed or refractory multiple myeloma.
Patients with primary plasma cell leukemia experienced high rates of response and improved progression-free survival when treated with bortezomib, dexamethasone plus doxorubicin or cyclophosphamide followed by transplantation.