Multiple myeloma (MM) is a common malignant neoplasm of the hematological system, which occurs in middle-aged and elderly people. In China, with the improvement of medical diagnosis and the aging of the population, the incidence rate is also increasing year by year, and MM is still considered as an incurable disease. There are many new drugs for MM treatment in recent years, and three new drugs were just approved by FDA in November this year, but for MM patients in China, it will take time for these new drugs to be really applied to the clinic, therefore, our so-called new drugs are still mainly the first generation bortezomib inhibitor – Vanco and the immunomodulator lenalidomide. The response rate of treatment represents the survival rate. Therefore, it is important to evaluate patients for initial therapy. Beyond the most basic tests before initial treatment, cytogenetic testing is increasingly important to allow us to develop treatment strategies according to different risk stratifications. In this section we will focus on the selection of these two new drug combination regimens. About the regimen containing bortezomib Bortezomib has a rapid onset of action and no renal impairment, making it very safe to use in patients with concomitant renal insufficiency. Due to the rapid onset of action of bortezomib-containing regimens, patients with high tumor load should be alerted to the development of tumor lysis syndrome. Dexamethasone should be given for 2-3 days before the application of bortezomib and should be applied with hydration and alkalinization, diuresis and protection of renal function. 2. (Bortezomib + cyclophosphamide + dexamethasone) and VAD ((Bortezomib + Adriamycin + dexamethasone) are basically similar in overall efficacy, but the risk of infection is higher in VAD. 3. Antiviral drugs and neurotropic drugs should be applied prophylactically. 4. Monitor patients closely for side effects, especially the appearance of peripheral neuropathy. Make dose adjustments in a timely manner. About the regimen containing lenalidomide Lenalidomide is a more effective immunomodulator than thalidomide, has a significant anti-MM effect and enhances the effect of hormones in the treatment regimen, and can be used in different regimens with hormones, cyclophosphamide and adriamycin, bortezomib, etc. The following issues should be noted in the application: 1. For patients with renal insufficiency: Rafumet® is excreted through the kidneys, but it does not mean that it is toxic to the kidneys; therefore, it can be used safely in patients with renal impairment through dose adjustment, and patients need to be closely monitored for renal function: biochemical examination. 2. Lenalidomide can cause a decrease in blood picture, so close monitoring of blood routine is required during application. 3, For the risk of thrombosis: patients who apply lenalidomide, especially those who apply hormones in combination are recommended to add anticoagulant drugs. As to when to choose a regimen containing bortezomib and when to apply a regimen containing lenalidomide, many factors such as the patient’s disease status, comorbidities and the patient’s own complaints should be evaluated comprehensively. Regardless of the regimen chosen, initial standardized treatment, adequate duration of therapy and monitoring of efficacy are essential for the overall treatment and survival of the patient, and attention should be paid to the elderly frail patients, for whom dose adjustments should be made according to the actual situation.