NCCN Guidelines for Patients
Multiple Myeloma, Version 1.2014
Treatments for myeloma
Surgery is rarely used as a treatment for myeloma.
It is only used to remove a solitary plasmacytoma
located outside of the bone. Radiation therapy is often
given before or after the surgery. Surgery is also used
to fix fractures in bones caused by myeloma.
Systemic therapy is the use of drugs to treat cancer
cells throughout the body. It is the main (primary)
treatment for multiple myeloma. Systemic therapies
for myeloma include chemotherapy, targeted therapy,
and steroids. This is also referred to as myeloma
When only one drug is used, it is called a single
agent. However, these drugs differ in the way
they work, so more than one drug is often used. A
combination regimen is the use of two or more drugs.
Targeted therapy is the use of drugs that are designed
to specifically target cancer cells. Targeted therapy is
less likely to harm normal cells than chemotherapy.
Some targeted therapies treat myeloma by stopping
the growth of new blood vessels that feed myeloma
cells in the bone marrow. Targeted therapies can also
block signals from proteasomes that help the myeloma
cells grow and survive. A type of targeted therapy
called an immunomodulator or immunomodulatory
agent stimulates the immune system to find and attack
See Chart 3.1
on page 26 for a list of
targeted therapy and other drugs that treat myeloma.
Order of treatments
Most people with myeloma will receive more than one type of treatment. When and why
treatments are given can be hard to understand. Part 4 gives full details. Here, the terms
that describe the order of treatments are explained.
The main treatment
given to rid the body
Treatment given to
keep cancer away
after the primary or
Treatment given after
failed to kill all of the
cancer or keep it away.