Choosing Drug Treatment

• Your doctor will take several factors into account when choosing treatment. These factors include the stage of your cancer, age, kidney health and whether or not you will be undergoing a stem cell transplant.
  
  

Chemotherapy

• Chemotherapy agents for treating multiple myeloma include melphalan, vincristine, cyclophosphamide, carmustine and doxorubicin. In most cases, you will receive a combination of at least two as this has proven more effective. Your doctor might also give you steroid drugs like dexamethasone or prednison to ease the side effects of treatment. You typically discontinue treatment when your M protein (type of antibody found in myeloma patients) levels stabilize; you might begin treatment again if they go up.
  
  

Immunomodulators

• Immunomodulators work to decrease immune system activity that encourages the production of abnormal plasma cells. Drugs commonly used to treat multiple myeloma include thalidomide and lenalidomide. While they share a similar chemical structure, lenalidomide appears to work better and causes less side effects. Thalidomide is used for newly diagnosed cases while lenalidomide treats both new and previously treated cases.
  
  

Proteasome Inhibitors

• Bortezomib blocks the action of proteasomes, which destroy proteins necessary for regulating cell division. It treats both new and previously treated patients.
  
  

Common Drug Combinations

• Doctors typically use a combination of drugs to treat multiple myeloma. Some common combinations include melaphalan and prednisone with or without thalidomide or bortezomib, vincristine, doxorubicin and dexamethasone, thalidomide and dexamethasone, bortezomib and dexamethasone, bortezomib, thalidomide and dexamethasone and doxorubicin, vincristine and dexamethasone.