The bone marrow (BM) milieu confers drug resistance in multiple myeloma (MM) cells
to conventional therapies. Novel biologically based therapies are therefore needed.
Preclinical studies have identified and validated molecular targeted therapeutics
in MM. In particular, recognition of the biologic significance of the BM microenvironment
in MM pathogenesis and as a potential target for novel therapeutics has already derived
several promising approaches. Thalidomide, lenalidomide (Revlimid), and bortezomib
(Velcade) are directed not only at MM cells but also at the BM milieu and have moved
rapidly from the bench to the bedside and United States Food and Drug Administration
approval to treat MM.
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