Microenvironment drug resistance in multiple myeloma: emerging new players

Lucia Di Marzo, Vanessa Desantis, Antonio Giovanni Solimando, Simona Ruggieri, Tiziana Annese, Beatrice Nico, Ruggiero Fumarulo, Angelo Vacca _ and Maria Antonia Frassanito

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Oncotarget. 2016; 7:60698-60711. https://doi.org/10.18632/oncotarget.10849

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Lucia Di Marzo1,*, Vanessa Desantis1,*, Antonio Giovanni Solimando1, Simona Ruggieri2, Tiziana Annese2, Beatrice Nico2, Ruggiero Fumarulo3, Angelo Vacca1 and Maria Antonia Frassanito3

1 Department of Biomedical Sciences and Human Oncology, Internal Medicine Section, University of Bari Medical School, Bari, Italy

2 Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy

3 Department of Biomedical Sciences and Human Oncology, General Pathology Section, Bari, Italy

* These authors have contributed equally to this work

Correspondence to:

Angelo Vacca, email:

Keywords: cancer-associated fibroblasts, drug resistance, exosomes, microRNAs, multiple myeloma

Received: May 05, 2016 Accepted: July 11, 2016 Published: September 13, 2016


Multiple myeloma (MM) drug resistance (DR) is a multistep transformation process based on a powerful interplay between bone marrow stromal cells and MM cells that allows the latter to escape anti-myeloma therapies. Here we present an overview of the role of the bone marrow microenvironment in both soluble factors-mediated drug resistance (SFM-DR) and cell adhesion-mediated drug resistance (CAM-DR), focusing on the role of new players, namely miRNAs, exosomes and cancer-associated fibroblasts.

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