Abstract
Steroids and alkylating agents have formed the backbone of myeloma therapy for decades with the result that patient outcomes improved very little over this period. The situation has changed recently with the advent of immunomodulatory agents and bortezomib, and patient outcomes are now improving. The introduction of bortezomib can be viewed as particularly successful as it was designed in the laboratory to fit a target that had been identified through biological research. As such, it has formed the template for new drug discovery in myeloma, with an increased understanding of the biology of the myeloma cell leading to the definition of upregulated pathways which are then targeted with a specific agent. This chapter will examine novel agents currently in development in the context of the abnormal biology of the myeloma cell and its microenvironment.
MeSH terms
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Alkylating Agents / therapeutic use
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Antineoplastic Agents
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Boronic Acids / therapeutic use
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Bortezomib
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Chromatin / genetics
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Chromatin / metabolism
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Histone Deacetylase Inhibitors / therapeutic use
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Humans
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Janus Kinase 2 / antagonists & inhibitors
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Janus Kinase 2 / metabolism
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Mitogen-Activated Protein Kinase Kinases / antagonists & inhibitors
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Mitogen-Activated Protein Kinase Kinases / metabolism
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Multiple Myeloma / drug therapy*
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NF-kappa B / antagonists & inhibitors
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NF-kappa B / metabolism
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Pyrazines / therapeutic use
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Signal Transduction
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Unfolded Protein Response / genetics
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Wnt Proteins / antagonists & inhibitors
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Wnt Proteins / metabolism
Substances
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Alkylating Agents
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Antineoplastic Agents
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Boronic Acids
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Chromatin
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Histone Deacetylase Inhibitors
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NF-kappa B
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Pyrazines
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Wnt Proteins
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Bortezomib
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Janus Kinase 2
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Mitogen-Activated Protein Kinase Kinases