Targeted therapies for myeloma

Targeted therapy drugs interfere with the way myeloma cells grow. You may be treated with thalidomide, lenalidomide or bortezomib.

About targeted and immunotherapy for myeloma

Targeted therapies are drugs that interfere with the way myeloma cells grow. Some targeted therapy drugs affect the immune system and help it to destroy myeloma cells. These are called immunotherapy drugs.

Types of targeted therapies for myeloma

The targeted therapies used for newly diagnosed myeloma are thalidomide, bortezomib and lenalidomide. You usually have these drugs along with chemotherapy drugs and steroids. Sometimes you have 2 targeted therapy drugs together.

Some people continue to take these types of drugs to help keep the myeloma under control. This is called maintenance or continuous treatment. Your doctor will explain if this is suitable for you.

When myeloma comes back (relapse), you may have other targeted therapy drugs. Sometimes 2 targeted therapies may be used in combination.

Your doctor and nurse will talk to you about the different treatment options.


Thalidomide is a targeted therapy drug and an immunotherapy drug. It helps the immune system attack and destroy cancer cells.


You may have bortezomib as a first treatment for myeloma, or if myeloma comes back after other treatment.


Lenalidomide affects the way the immune system works. It also blocks the development of new blood vessels, which cancer cells need to grow and spread.

Side effects of targeted therapy for myeloma

Like all drugs, targeted therapies can cause side effects. It is important to tell your cancer doctor or nurse if you have any side effects while you are having treatment. They may adjust your treatment to control side effects or to help to prevent more serious problems.

 Both thalidomide and lenalidomide can cause birth defects in developing babies. This can happen if a pregnancy starts when either a man or woman is taking these drugs. Women who have not yet had the menopause will take part in a pregnancy prevention programme while taking thalidomide or lenalidomide. Your doctor will give you information about not becoming pregnant or making someone pregnant during treatment, and for at least 4 weeks after treatment. You also have pregnancy tests before starting this treatment. 

 If you think you or your partner might be pregnant during your treatment, contact your doctor or specialist nurse straight away.

 Thalidomide and lenalidomide can also increase the risk of a blood clot developing. Your doctor may ask you to take drugs to thin your blood to reduce this risk.

 Some other side effects of these drugs include:

  • constipation
  •  drowsiness
  •  an increased risk of infection
  •  feeling sick
  •  numbness or tingling  in the hands and feet (peripheral neuropathy)
  • tiredness (fatigue).
Related pages

About our information

  • References

    Below is a sample of the sources used in our myeloma information. If you would like more information about the sources we use, please contact us at

    National Institute for Health and Care Excellence (NICE). Myeloma: diagnosis and management. NICE guideline [NG35]. Published: 10 February 2016 Last updated: 25 October 2018. Available from: Accessed: 19/07/22

    Jonathan Sive et al., on behalf of the British Society of Haematology. British Journal of Haematology. Guidelines on the diagnosis, investigation and initial treatment of myeloma: a British Society for Haematology/UK Myeloma Forum Guideline. Published: 21 March 2021 Available from: Accessed: 19/07/22

    M.A. Dimopoulos et al. Annals of oncology. European Society for Medical Oncology (ESMO). Multiple myeloma: EHA-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Volume 32, ISSUE 3, P309-322, March 01, 2021. Available from: Accessed: 19/07/22

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Anne Parker, Consultant Haematologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

  • use plain English
  • explain medical words
  • use short sentences
  • use illustrations to explain text
  • structure the information clearly
  • make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.

Date reviewed

Reviewed: 31 August 2021
Next review: 31 August 2024
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.