Chemotherapy, also known as anti-cancer agents or antineoplastics, is a treatment that kills cancer cells. It can be taken orally (by mouth), or intravenously (through the vein). High-risk multiple myeloma patients with advanced stages of myeloma are often treated with chemotherapy.

Chemotherapy aims to suppress multiple myeloma by targeting cancer cells which characteristically grow at uncontrollable rates. Chemotherapy is toxic to cancer cells and takes effect as the cells multiply. However, chemotherapy can also eliminate healthy cells - especially ones that divide rapidly in the body. For example, cells in the lining of the gastrointestinal tract, hair follicles, and bone marrow, which naturally grow at high rates, are inadvertently targeted by chemotherapy.

Patients should consult their doctors before deciding what preparations and combinations are appropriate for their chemotherapy treatment.

Chemotherapy Drugs Used for Multiple Myeloma
Cyclophosphamide (Cytoxan) ^[1]
Dexamethasone (Decadron) ^[2], may be used alone
Doxorubicin (Adriamycin) ^[3]
Melphalan (Alkeran) ^[4]
Prednisone ^[5]
Vincristine (Oncovin) ^[6]

Chemotherapy Combinations

Combination chemotherapy uses multiple drugs to improve efficacy and to decrease the chances of developing cancer cells that are resistant to one agent. The different drugs can be used simultaneously at an optimal dose, without severe side effects. Patients with advanced stages of cancer, who are not suitable for other treatments like radiation therapy and surgery, often turn to combination chemotherapy.

MP
Melphalan (Alkeran) ^[4]
Prednisone ^[5]

MP, a combination of an immunosuppressant and a chemotherapy agent, is a standard combination for multiple myeloma patients who are not candidates for high-dose therapy and stem cell support. Although MP is used frequently and various studies show a response rate of 50 percent with a median overall survival of three years, researchers are continually searching for other combinations with melphalan and prednisone. Currently, studies are being conducted with other drugs such as thalidomide ^[7] (Thalomid) , Velcade ^[8] (bortezomib), Revlimid ^[9] (lenalidomide), and more.

VAD
Vincristine (Oncovin) ^[6]
Doxorubicin (Adriamycin) ^[3], given by IV, continuous infusion
Dexamethasone (Decadron) ^[2], taken by mouth

VAD is a common combination for patients who have previously been untreated for multiple myeloma. This type of chemotherapy treatment, which is referred to as an induction therapy, is used in an effort to reduce tumors before patients undergo a stem cell transplant. VAD showed varying response rates from approximately 50 to 70 percent in different studies.