As 2014 comes to an end, what research advances have been made in hematologic malignancies in the past year? MEDSCAPE invites heavyweight experts to take stock of this, including advances in disease treatment and new drugs. Multiple Myeloma (MM) Recently, the International Multiple Myeloma Working Group updated its definition of MM, which will have a significant clinical impact. In addition to the necessary symptoms of CRAB (hypercalcemia, renal failure, anemia, and bone destruction) to diagnose MM, the definition includes markers that predict early CRAB symptoms. In the past, our definition of MM was that patients had to have CRAB symptoms prior to treatment. However, symptoms such as renal failure and bone destruction are often not obvious, and the new guidelines make some adjustments in this regard. Clinically, treatment can be initiated if the bone marrow plasma cells exceed 60%, if the serum free light chain ratio is greater than 100, or if magnetic resonance imaging shows two or more lesions. In terms of MM treatment, researchers at the recent ASH meeting presented promising results from the ASPIRE Study III clinical trial. For relapsed MM, a combination of carfilzomib and lenalidomide in combination with dexamethasone regimen improved disease-free survival (PFS) by 6 months. Noopur Raje, MD, of the Multiple Myeloma Treatment Group at Massachusetts General Hospital, says, “Carfilzomib was approved several years ago for bortezomib-resistant patients, and the ASPIRE study was only a validation clinical trial.” Several other new drugs for MM are also in clinical trials in 2014. Takeda’s (Takeda) ixazomib in combination with dexamethasone and lenalidomide for MM is currently in a Phase III trial with good Phase 1/2 data. In addition, at this year’s ASCO meeting, researchers presented results from phase 2 trials of daratumumab (Genmab) and SAR650984 (Sanofi), which also showed good data. Both of these new drugs showed good single-agent activity. At the ASH meeting, researchers presented results from a Phase 2 clinical trial of daratumumab, dexamethasone in combination with lenalidomide for relapsed refractory MM, with a response rate of more than 80% and daratumumab now in the fast track for approval. SAR650984 was not far behind, with a response rate of approximately 65% in a clinical study of SAR650984, lenalidomide and dexamethasone regimens for relapsed refractory MM. 65%. There are good outcomes and there are definitely bad outcomes. Novartis’ histone deacetylase (HDAC) inhibitor, panobinostat, failed. According to Novartis’ study results published in ASCO, adding panobinostat to the BD regimen (bortezomib, dexamethasone) for relapsed refractory MM improved the PFS of patients by 4 months. It was expected that Pabixista would be approved for marketing, but the FDA voted against it because of its toxic effects. The efficacy of HDAC inhibitors in combination with other drugs is not yet known.