Multiple myeloma is a type of cancer that affects the plasma cells in bone marrow, which produce antibodies to fight infections.

This cancer occurs when the plasma cells grow out of control and produce abnormal proteins, called monoclonal proteins, which can cause damage to organs in the body. Multiple myeloma can be treated, but there is no cure, and most people with the disease will eventually relapse.

However, recent advances in multiple myeloma research have yielded promising new treatments that are improving outcomes for patients.

These treatments include immunotherapies, targeted therapies, and combination therapies that use multiple drugs to attack the cancer cells in different ways.

Immunotherapies

Immunotherapies are drugs that stimulate the immune system to attack cancer cells. One type of immunotherapy that has shown promise for multiple myeloma is CAR-T cell therapy.

CAR-T cell therapy involves removing T cells from a patient’s blood, genetically modifying them to recognize and kill cancer cells, and then infusing them back into the patient’s body. In a clinical trial of CAR-T cell therapy for multiple myeloma, 33% of patients achieved a complete response, and the median progression-free survival was 11.8 months.

Another type of immunotherapy for multiple myeloma is checkpoint inhibitor therapy. Checkpoint inhibitors are drugs that block proteins on the surface of immune cells that prevent them from attacking cancer cells.

In a clinical trial of checkpoint inhibitor therapy combined with a targeted therapy called lenalidomide, the overall response rate was 65%, and the median progression-free survival was 12.9 months.

Targeted Therapies

Targeted therapies are drugs that attack specific molecules or pathways that are involved in the growth and survival of cancer cells. One targeted therapy that has shown promise for multiple myeloma is venetoclax.

Venetoclax is a drug that targets a protein called BCL-2, which helps cancer cells survive by preventing a form of cell death called apoptosis. In a clinical trial of venetoclax combined with a type of chemotherapy called bortezomib, the overall response rate was 82%, and the median progression-free survival was 22.4 months.

Another targeted therapy for multiple myeloma is selinexor. Selinexor is a drug that targets a protein called XPO1, which is involved in the regulation of genes that promote cell growth and survival.

In a clinical trial of selinexor combined with a type of chemotherapy called dexamethasone, the overall response rate was 26%, but the treatment was particularly effective in patients with high-risk genetic abnormalities. The median progression-free survival was 8.6 months.

Combination Therapies

Combination therapies are drugs that use multiple drugs to attack cancer cells in different ways. One combination therapy that has shown promise for multiple myeloma is the combination of daratumumab, bortezomib, and dexamethasone.

Daratumumab is a monoclonal antibody that targets a protein called CD38, which is highly expressed on myeloma cells. In a clinical trial of this combination therapy, the overall response rate was 83%, and the median progression-free survival was 16.6 months.

Another combination therapy for multiple myeloma is the combination of carfilzomib, lenalidomide, and dexamethasone.

Carfilzomib is a targeted therapy that inhibits the activity of proteasomes, which are proteins that break down other proteins, including those that promote the growth and survival of cancer cells. In a clinical trial of this combination therapy, the overall response rate was 87%, and the median progression-free survival was 23.5 months.

Conclusion

Multiple myeloma is a challenging cancer to treat, but recent advances in research have yielded promising new treatments that are improving outcomes for patients.

Immunotherapies, targeted therapies, and combination therapies are all showing promise for multiple myeloma, and clinical trials are ongoing to further refine these treatments and find new ones. While there is still no cure for multiple myeloma, these new treatments are extending the lives of patients with this disease and giving them hope for the future.