Microenvironment Regulation and Targeted Therapy for Multiple Myeloma Bone Disease

Multiple myeloma bone disease (MBD) is one of the most common clinical complications associated with multiple myeloma (MM). Skeletal-related events (SREs) caused by MBD significantly impair patients' quality of life and prognosis. Anti-bone resorption drugs are the main therapeutic approach and have been effective in controlling bone disease. However, these treatments are still limited by drug-related side effects and limited therapeutic efficacy. With the in-depth investigation into the pathogenesis of MBD, modulation of the bone marrow microenvironment has gradually emerged as a novel therapeutic direction for the treatment of multiple myeloma bone disease. This review aims to concisely describe the mechanisms by which the bone marrow microenvironment contributes to multiple myeloma bone disease and to discuss the targeted therapeutic strategies based on the modulation of the microenvironment.