Which therapies will move to the front line for multiple myeloma?

INTRODUCTION: Despite substantial progress, multiple myeloma (MM) remains an incurable disease. Recently the availability of several novel drugs with different and innovative mechanisms of action (daratumumab, elotuzumab, carfilzomib, ixazomib, and panobinostat) has increased the therapeutic options but has also increased complexity in the management of patients with MM. Areas covered: The outstanding results observed in the relapsed setting with regimens including these new drugs has provided the investigators with several treatment options that are being tested also in patients with newly diagnosed MM. Fully published phase 2 and randomized, phase 3 trials including new drugs in patients with relapsed and/or refractory MM have been reviewed. In addition, the progressive incorporation of these new drugs in the front-line treatment of MM and the potential impact of these new therapies in the management of patients with newly diagnosed MM has also been addressed. Expert commentary: In the near future, several novel anti-MM drugs will move from the relapsed to the front-line setting. While the increasing range of effective therapeutic agents is very encouraging it adds to the complexity of treatment decisions and prospective trials are needed to help clinicians to determine which could be the best therapeutic approaches for the different subgroups of patients with newly diagnosed MM.