Treatment of Multiple Myeloma: Finding the Right Combination.

The treatment of multiple myeloma is evolving rapidly. The development of immunomodulatory drugs (IMiDs) in the late 1990s and proteasome inhibitors (PIs) in the first decade of this century has dramatically changed the outlook for patients, as we began seeing response rates never before imagined. Today the so-called novel agents are no longer novel but standard of care, and are being joined by a host of new therapeutics. The use of next-generation IMiDs and PIs is further complemented by histone deacetylase inhibitors (HDACIs), monoclonal antibodies, selective inhibitors of nuclear export, and other agents. Clearly, the number of available new drugs to treat multiple myeloma has outpaced our understanding of the best way to incorporate them into our treatment regimens.