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Multiple myeloma tumor cells demonstrate multiple and often complex genetic lesions as evaluated by standard cytogenetic/FISH studies. Over the past decade, specific abnormalities have been associated with standard or high-risk clinical behavior and they have become strong prognostic indicators. Further, as evidenced by recent randomized clinical trials, the choice of front-line therapy (transplant vs. no transplant, inclusion of novel drugs such as bortezomib, thalidomide, and lenalidomide) may be able to overcome the adverse effect of high-risk genetic lesions.

The past decade has seen significant progress in the development of new and effective therapies for multiple myeloma. Stem cell transplantation and the introduction of novel agents, such as thalidomide, lenalidomide, and bortezomib, have significantly improved outcomes of myeloma patients. In the current review, we analyzed the available data provided by published randomized clinical trials for the frontline therapy of myeloma patients. We attempted to assess the relative contribution and impact of these new therapies in the setting of both, transplant eligible and transplant ineligible patients.

Until recently, the best protection against breast cancer mortality was early diagnosis through mammographic screening. However, the possibility that breast cancer in some cases can be prevented has come to light over the past 30 years. Various risk reduction strategies of breast cancer have been explored including lifestyle modification, prophylactic surgeries, and the use of chemopreventive agents. This article is the second portion of a two-part series on breast cancer prevention, and will focus its discussion on the available risk reduction interventions that have been shown to prevent breast cancer in women considered high risk for the disease. (See Part I in Cancer Investigation, 28:743–750, 2010)

Advances in breast cancer research have led to declining death rates from this disease because of early detection through mammographic screening and improved therapy for breast cancer. The concept that breast cancer, in some cases, can be prevented has been explored over the last three decades. This article, part I of a two-part series, will focus on the epidemiology, the risk factors associated with breast cancer, and the available risk assessment tools, which can help define who should be considered for risk reduction strategies. Part II will focus on discussing risk reduction strategies.

Phase III clinical trials help define standard therapies by comparing the outcomes of a new (experimental) treatment arm to the best established (control) arm. Superior outcomes should only be defined in measures of patient benefit. Two recent trials for upfront therapy of patients with multiple myeloma (ECOG E1A00 and E4A03) failed to conform to traditional Phase III trial design. Consequently they failed to provide any useful scientific data.