Angiogenesis inhibition, hypoxia, and targeting the bone marrow microenvironment in multiple myeloma: new strategies and targets
Multiple myeloma (MM) is a hematological B-cell malignancy that has still a fatal prognosis. Although the treatments have improved, one major problem in MM is the clinical resistance to available drugs and combination therapies over time. Novel agents, such as oral proteasome inhibitors, monoclonal antibodies, second generation immunomodulatory drugs and therapies targeting the cell signaling and the tumor microenvironment are in development for the treatment of relapsed/refractory MM. In this review, we refer on the role of new strategies targeting the tumor microenvironment, especially on angiogenesis, hypoxia and other interactions between MM and bone marrow components.