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.

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