The Myeloma UK Clinical Trial Network (CTN) has achieved another significant milestone with data from the MUK six trial published in the latest issue of Lancet Haematology. MUK six, a Phase I/II multicentre open label trial aimed to determine the safety and both the optimum and maximum dose of panobinostat when used in combination with once-weekly Velcade, dexamethasone and low-dose thalidomide (P-VTD) in relapsed and/or refractory myeloma patients. Of the 57 patients who received at least one dose of panobinostat, only one dose-limiting toxicity (grade 3 hyponatremia) at 20 mg was reported, however the maximum tolerated dose was not reached and 20 mg was chosen recommended dose. In further analyses, 42 out of 46 patients (91%) achieved an overall response equal or greater than a partial response with the depth of response higher in those treated at first relapse than those at later stages. Responses were similar whether or not patients had previously been treated with Velcade. Median progression-free survival was 15.6 months while median overall survival had not been reached after a median follow up of 15 months. Most side-effects were grade 1 – 2 with he most commonly reported being educed neutrophil count and hypophosphatemia. The authors conclude that the four drug combination of P-VTD is a safe and effective treatment for myeloma patients, particularly when given earlier in the currently indicated treatment pathway.