[New treatment strategy of multiple myeloma for cure]

Multiple myeloma has long been considered an incurable disease. Indeed, the median survival time in patients treated with conventional chemotherapy has been reported to be about 3 years, and the survival rate decreased consecutively and was about 2 to 3% at 10 years. However, after introduction of autologous stem-cell transplantation in the 1990s, the median survival time was improved to about 5 years. Furthermore, novel drugs have been introduced in the treatment of patients with relapsed/refractory multiple myeloma, and improved the prognosis of these patients. Thalidomide, which has anti-angiogenetic activity, has a 30-40% response rate, and the combination of thalidomide and dexamethasone has a 40-50% response rate. Lenalidomide, which is a thalidomide analog, has a higher efficacy and lower incidence of adverse effects than thalidomide. Bortezomib, which is a proteasome inhibitor and inhibits NF-kappaB activity, has also excellent efficacy like thalidomide. The clinical trials using these drugs for newly diagnosed patients are now ongoing around the world, and show very excellent results. The good combination of stem-cell transplantation and novel drugs may well improve the prognosis of patients with multiple myeloma, and induce a cure,especially in young patients.