The interaction between multiple myeloma (MM) cells and cellular components and its (BM) microenvironment promotes MM cell growth and osteolytic bone destruction. Osteolytic bone disease, characterized by bone pain, increased risk of pathologic fractures, tumor-induced hypercalcemia, is a frequent complication of MM patients. These skeletal-related events (SREs) decrease their quality of life and reduce their survival. Therefore, therapeutic strategies targeting the interplay between MM cells and the BM cellular components, including osteoclasts (OCs), stromal cells as well as MM cells themselves are necessary not only to attain tumor regression but to reduce its associated bone disease. The goal of bone-targeted therapy in MM is to reduce or delay the incidence of SREs and to improve the quality of life in affected patients. Currently, several novel agents are in the clinical trials.

multiple myeloma, bone marrow microenvironment, osteoclast, skeletal-related events, bone-targeted therapy