I am posting this article because I found it to be an excellent summary and it points out some issues that have been confusing in the past.
"While each of these
agents has individual activity against multiple myeloma, it’s the
enhanced activity gained by combining them with older, established
agents, such as the glucocorticoid dexamethasone and the alkylating
agents melphalan and cyclophosphamide, that has produced the most
headway against the disease in recent years. “Such combinations produce
more effective anti-myeloma activity with less added toxicity,†Dr.
Alexanian said. Also, the newer agents can sometimes resensitize
myeloma that has become refractory to previously administered drugs."
" When pain or
dangerous side effects are present, as they are in about 80%–85% of
newly diagnosed patients, it is important to rapidly achieve complete
remission, or as close to it as possible, Dr. Alexanian said. Not only
does a quick and complete remission help the patient avoid repeated
cycles of potentially toxic therapy, but remission status after initial
therapy is also a predictor of how long the patient will live. Complete
remission is associated with a median overall survival of 10 years,
while patients who achieve partial remission or no remission have
median overall survival durations of 5 years and 2.5 years,
respectively."
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