Review Article

Innovative Agents in Multiple Myeloma

Beth Faiman, PhDc, MSN, APN-BC, AOCN®, and Tiffany Richards, MS, ANP, AOCNP®

From Cleveland Clinic Foundation, Cleveland, Ohio, and University of Texas MD Anderson Cancer Center, Houston, Texas

Authors' disclosures of potential conflicts of interest are found at the end of this article.

Beth Faiman, PhDc, MSN, APN-BC, AOCN®, Cleveland Clinic Foundation, 9500 Euclid Avenue R35, Cleveland, OH 44195. E-mail: faimanb@ccf.org


J Adv Pract Oncol 2014;5:193–202 | DOI: 10.6004/jadpro.2014.5.3.4 | © 2014 Harborside Press®


  

ABSTRACT

Abstract

Multiple myeloma (MM) remains an incurable cancer of the bone marrow plasma cells. However, the overall survival of patients with MM has increased dramatically within the past decade. This is due, in part, to newer agents such as immunomodulatory drugs (lenalidomide, thalidomide, and pomalidomide) and proteasome inhibitors (bortezomib, carfilzomib, MLN9708). These and several other new classes of drugs have arisen from an improved understanding of the complex environment in which genetic changes occur. Improved understanding of genetic events will enable clinicians to better stratify risk before and during therapy, tailor treatment, and test the value of personalized interventions. The ultimate goal in this incurable disease setting is to reduce the impact of cancer- or chemotherapy-related side effects. Nurses and advanced practitioners are integral to the treatment team. Thus, each should be aware of changes to the current drug landscape. Targeted drugs with sophisticated mechanisms of action are currently under investigation. Patients gain access to newer drugs within the context of clinical trials. Awareness of such trials will help accrual and determine if therapeutic benefit exists. In this article, we will describe new agents with unique and targeted mechanisms of action that have activity in patients with relapsed and/or refractory multiple myeloma.




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