The most important clinical distinction in the first-line treatment of multiple myeloma is determining whether the patient is eligible to undergo autologous stem-cell transplantation (ASCT). Approximately one-quarter of diagnosed multiple myeloma patients are not eligible to undergo a transplant owing to their age and/or performance status. For years, melphalan-based regimens were the standard of care for these patients, but Celgene’s Revlimid and Thalomid/Thalidomide and Janssen/Takeda’s Velcade have revolutionized the treatment of transplant-ineligible multiple myeloma patients and are now the cornerstones of therapy. Nevertheless, because of the older age and comorbidities of most ASCT-ineligible patients, physicians must focus on treating the symptoms of the disease while managing the toxicity of treatment and improving patients’ quality of life. Thus, significant unmet need remains for well-tolerated agents that can also delay disease progression and extend the survival of this frail patient subpopulation.
Provides quantitative insight into U.S. and European physician perceptions of key treatment drivers and goals and the current level of unmet need for a specific disease. Commercial opportunities are analyzed, and the extent to which emerging therapies may capitalize on these opportunities is evaluated.
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