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Novel approaches in the treatment of multiple myeloma.

Despite all the new advances, treatment of multiple myeloma remains very challenging. Table 6 summarizes the outcomes of some of the commonly used treatments from different clinical trails. Treatment with conventional chemotherapy alone resulted in median survival from 18 to 30 months. Aggressive treatments like VBMCP (vincristine, bleomycin, melphalan, cyclophosphamide, predisone) although resulting in higher response rates, resulted in higher treatment-related mortality and did not have any effect on median and 5 year survival. High dose chemotherapy with stem cell support increased the median survival to around 60 months and resulted in durable complete responses in a significant number of the patients. Some of the newer and promising treatments for multiple myeloma are summarized in Table 7.