SIE, SIES, GITMO evidence-based guidelines on novel agents (thalidomide, bortezomib, and lenalidomide) in the treatment of multiple myeloma Annals of Hematology, 04/11/2012

Barosi G et al. – In patients who are refractory or relapsing after first–line therapy, the authors recommended bortezomib and pegylated liposomal doxorubicin, or lenalidomide and dexamethasone combinations (weak positive).

• The authors used the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) system which separates the judgments on quality of evidence from the judgment about strength of recommendations.
• They recommended thalidomide and bortezomib in MM patients candidates to autologous stem cell transplantation (ASCT) (weak positive).
• They did not recommend novel agents as maintenance therapy after ASCT (weak negative).
• In patients not candidate to ASCT, thalidomide or bortezomib (strong positive) associated with melphalan and prednisone were recommended.
• In these patients, no specific course of action could be recommended as for maintenance therapy.