Oral Therapies for Multiple Myeloma

Multiple myeloma is a haematological cancer that needs continuous long-term management for improved outcomes and survival. Over the last few decades, medical therapies for myeloma have improved considerably, with several new drug classes becoming available. Oral therapies, especially when used in combinations, are more convenient than intravenous therapies, and limit the number of clinic visits. Oral therapies include thalidomide, lenalidomide, pomalidomide, ixazomib, panobinostat, selinexor, venetoclax, melphalan and cyclophosphamide. Cytopenias were the most common adverse events with the immunomodulatory drugs panobinostat, selinexor and venetoclax, while skin rash was seen commonly with ixazomib and lenalidomide. Oral regimens are imperative during a global pandemic and can be managed over telemedicine visits rather than outpatient infusions and injections, reducing the risk of exposure and infection. It is important that patients monitor their side effects and report them to their healthcare providers at the earliest opportunity. We review available oral regimens and their combinations for effective management of myeloma.