NCCN CLINICAL PRACTICE GUIDELINES IN ONCOLOGY Multiple Myeloma, Version 3.2021

Multiple myeloma is a malignant neoplasm of plasma cells that ac- cumulate in bone marrow, leading to bone destruction and marrow failure. This manuscript discusses the management of patients with solitary plasmacytoma, smoldering multiple myeloma, and newly diagnosed multiple myeloma. route. The fi ndings from the study demonstrate noninferior e ffi cacy with subcutaneous versus intravenous bortezomib with regard to the primary endpoint (ORR after 4 cycles of single-agent bortezomib). The results reported during the 2015 ASH meeting show that patients who received bortezomib/thalidomide/ dexamethasone as induction therapy achieved higher ORR (92.3%) compared with those who received CyBorD (84%). Those who received bortezomib/thalidomide/ dexamethasone had signi fi cantly greater VGPR ( P 5 .04) and PR ( P 5 .02) rates. 89 The hematologic toxicity was greater in the CyBorD arm; however, higher rates of peripheral neuropathy were reported in the bortezomib/ thalidomide/dexamethasone arm. 89 No signi fi cant dif-ference in OS was observed in any of the trials with bortezomib/thalidomide/dexamethasone. A longer fol-low-up period is required.