 Newer agents and their combinations appear to provide higher response rates and higher CR rates. One of the new active agents in multiple myeloma is Velcade bortezomib, formerly known as PS-341. This molecule has a novel mechanism of action by specifically inhibiting the proteasome. In a reported phase II trial, Velcade as a single agent induced at least minimal responses MR in 35 of patients and CR in 4 of patients, and at least a stabilization of the disease in 59 of patients with heavily pretreated, relapsedrefractory multiple myeloma using strict SWOG criteria. Velcade alone is superior than dexamethasone pulses in a phase III randomized study in patients with at least one but no more than 3 lines of therapy. Preliminary reports indicate that combinations of Velcade with other active anti-myeloma agents appear to provide superior outcomes than Velcade alone. An additional 18 of patients responded when dexamethasone was combined with Velcade in a patient population refractory to Velcade alone. Velcade with Doxil was shown to produce high response rates in a phase I study with 60 PR rate and 20 CR rate and acceptable toxicity in patients with relapsedrefractory multiple myeloma. There is only limited data on the outcomes of treatment of newly diagnosed patients with myeloma with Velcade or its combinations. Velcade as a single agent has been shown to have impressive response rate in newly diagnosed patients with 55 percent of patients achieving at least PR and 77 of patients achieving at least MR as per preliminary report from a phase II study. Treatment with Velcade did not appear to affect stem cell collection. 