Place in therapy of innovative drugs in multiple myeloma in 2021 and 2023 according to an expert panel Delphi consensus


  • Mario Boccadoro Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Torino - Italy
  • Patrizia Berto Certara Italy, Milano - Italy
  • Sara Bringhen Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Torino - Italy
  • Elena Zamagni “Seràgnoli” Institute of Hematology, Università degli Studi, Azienda Ospedaliero-Universitaria di Bologna, Bologna - Italy
  • Patrizia Tosi Hematology Unit, Ospedale di Rimini, Rimini - Italy
  • Nicola Cascavilla Division of Hematology, Ospedale “Casa Sollievo della Sofferenza” IRCCS, San Giovanni Rotondo - Italy
  • Nicola Giuliani Division of Medicine and Surgery, Università di Parma and Hematology Unit, CTMO, AOU di Parma - Italy
  • Donato Mannina Division of Hematology, Azienda Ospedaliera Papardo, Messina - Italy
  • Renato Zambello Hematology and Clinical Immunology, Padua University School of Medicine, Padua - Italy
  • Francesca Patriarca Division of Hematology, Azienda sanitaria Universitaria Friuli Centrale, DAME, Udine University, Udine - Italy
  • Vittorio Montefusco Division of Onco-Hematology, ASST Santi Paolo e Carlo, Milano - Italy
  • Mariella Grasso Azienda Ospedaliera S. Croce-Carle, Cuneo - Italy
  • Francesco Di Raimondo Division of Hematology, Azienda Policlinico-S. Marco-Catania, and Department of Surgery and Medical Specialties, University of Catania, Catania - Italy
  • Massimo Offidani Hematology Clinic, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Ancona - Italy
  • Maria Teresa Petrucci Hematology, Department of Translational and Precision Medicine, Azienda Ospedaliera Policlinico Umberto I, Università “La Sapienza”, Rome - Italy
  • Pellegrino Musto Unit of Hematology and Stem Cell Transplantation, Aldo Moro University School of Medicine, AOU Consorziale Policlinico, Bari - Italy



Delphi Panel, European Myeloma Network, Monoclonal antibodies, Multiple myeloma


Introduction: The objective of this study was to understand the potential use of single agents and drug combinations in multiple myeloma (MM) across treatment lines in the years 2021 and 2023.

Methods: The method used was Delphi Panel Method survey, administered to European Myeloma Network (EMN) Italy Working Group centres. Future treatments were identified assessing all available web-based information sources, including therapies (single drugs or combinations) with strong evidence of efficacy, likely to be on the Italian market in 2021 and 2023. Participants were asked to report on the likelihood of prescription for MM therapies, across treatment lines.

Results: Across the 15 centres taking part in the survey, about 890 patients per year are forecasted to receive a new diagnosis of MM. In 2021, the Panel forecasted 66% of 1L-TE (transplant eligible) patients will be treated with bortezomib-thalidomide-dexamethasone (VTD) and 32% of patients with daratumumab-bortezomib-thalidomide-dexamethasone (DVTd), with a substantial decrease of VTD (15%) and a marked increase of DVTd (81%) forecasted for 2023. The 2L and 3L R(lenalidomide)-based combination treatments are expected to drop and will likely be substituted by a steep increase in P(pomalidomide)-based regimes (from 7% to 23%). On the contrary, in 3L treatment, all combination therapies (with the exception of IsaPd – isatuximab-pomalidomide-dexamethasone) are expected to lose market share in favour of the most recent new therapies.

Conclusions: Expert Panel agrees that many different new drugs and combinations will be used in MM, with different mechanisms of action, both at diagnosis and in subsequent phases of the disease, with a corresponding decline of the drugs currently used.


Download data is not yet available.


AIOM Associazione Italiana Oncologia Medica. Linee Guida Mieloma. Edizione 2017 Online (accessed November 2020).

Kumar SK, Rajkumar V, Kyle RA, et al. Multiple myeloma. Nat Rev Dis Primers. 2017;3(1):17046. PMID:28726797 DOI:

Abramson HN. B-cell maturation antigen (BCMA) as a target for new drug development in relapsed and/or refractory multiple myeloma. Int J Mol Sci. 2020;21(15):5192. PMID:32707894 DOI:

European Medicines Agency Sarclisa – isatuximab. Online (accessed November 2020).

Shah N, Chari A, Scott E, Mezzi K, Usmani SZ. B-cell maturation antigen (BCMA) in multiple myeloma: rationale for targeting and current therapeutic approaches. Leukemia. 2020;34(4):985-1005. PMID:32055000 DOI:

Acone B, Urbani A. The Delphi Method: The methodology and its application. JHA. 2018;S1(S1):9-14. DOI:

Trevelyan EG, Robinson N. Delphi methodology in health research: how to do it? Eur J Integr Med. 2015;7(4):423-428. DOI:

Hsu CC, Sandford BA. The Delphi Technique: making sense of consensus. Pract Assess Res Eval. 2007;12(10). (accessed November2020).

Dalkey N, Helmer O. An experimental application of the Delphi Method to the use of experts. Manage Sci. 1963;9(3):458-467. DOI:

Kerlinger FN. Foundations of behavioural research. New York: Holt, Rinehart, and Winston, Inc 1973.

Linstone HA, Turoff M. The Delphi method: techniques and applications. Reading, MA: Addison-Wesley Publishing Company 1975.

Dalkey NC, Rourke DL. Experimental assessment of Delphi procedures with group value judgments. In: Dalkey NC, Rourke DL, Lewis R, et al, eds. Studies in the quality of life: Delphi and decision-making. Lexington, MA: Lexington Books 1972; 55-83.

Additional Files



How to Cite

Boccadoro, M., Berto, P., Bringhen, S., Zamagni, E., Tosi, P., Cascavilla, N., Giuliani, N., Mannina, D., Zambello, R., Patriarca, F., Montefusco, V., Grasso, M., Di Raimondo, F., Offidani, M., Petrucci, M. T., & Musto, P. (2021). Place in therapy of innovative drugs in multiple myeloma in 2021 and 2023 according to an expert panel Delphi consensus. Global and Regional Health Technology Assessment, 8(1), 80–86.



Original Research Articles


Received 2021-02-17
Accepted 2021-05-28
Published 2021-07-17


Most read articles by the same author(s)