For Health Care Professionals Outside the US


Multiple myeloma is a complex, incurable disease where all patients eventually progress1,2

By second relapse, most patients are exposed to proteasome inhibitors (PIs) and immunomodulatory drugs (IMiDs)2

Multiple myeloma treatment progression
How is progression defined?

While current treatments may provide a clinical benefit in the relapsed setting, not all patients may respond. Many ultimately relapse or become refractory to other therapies3-5

  • Throughout a patient’s multiple myeloma journey, they may cycle through numerous PI and IMiD regimens, consequently cycling between these 2 mechanisms of actions
  • Despite treatment options, recycling of treatments may lead to drug resistance and progression of multiple myeloma3,5
  • Most patients eventually relapse or become refractory to treatment due to changing tumour biology and the development of aggressive, drug-resistant phenotypes6


  1. Dimopoulos K, Gimsing P, Grønbæk K. The role of epigenetics in the biology of multiple myeloma. Blood Cancer J. 2014;4:e207.
  2. Hajek R. Strategies for the treatment of multiple myeloma in 2013: moving toward the cure, multiple myeloma - a quick reflection on the fast progress. Published online April 10, 2013. Accessed April 28, 2015.
  3. Cea M, Cagnetta A, Gobbi M, et al. New insights into the treatment of multiple myeloma with histone deacetylase inhibitors. Curr Pharm Des. 2013;19(4):734-744.
  4. De Bruyne E, Bos TJ, Schuit F, et al. IGF-1 suppresses Bim expression in multiple myeloma via epigenetic and posttranslational mechanisms. Blood. 2010;115(12):2430-2440.
  5. Abdi J, Chen G, Chang H. Drug resistance in multiple myeloma: latest findings and new concepts on molecular mechanisms. Oncotarget. 2013;4(12):2186-2207.
  6. Dimopoulos MA, San-Miguel JF, Anderson KC. Emerging therapies for the treatment of relapsed or refractory multiple myeloma. Eur J Haematol. 2011;86(1):1-15.