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Treatments for multiple myeloma — a cancer of blood plasma cells — have improved significantly over the past decade, and researchers predict even bigger gains in the next decade.1
According to Dr. Clay Smith, program director of the Blood Cancer & BMT Program at the University of Colorado School of Medicine, average life expectancy for a patient diagnosed with multiple myeloma is now seven to 10 years, up from two to three years in the 1990s.2 In some instances, patients are living as long as 20 years.3
“The progress that’s been made since the end of the 1990s and the early 2000s is just remarkable,” Smith says. “And the pace of that progress seems to be picking up.”
Improvements are accelerating, in part, because of recent advances in targeted therapy, which attacks specific features of myeloma cells.4 These targeted treatments include a method known as proteasome inhibition.
“A part of the myeloma cell, called the proteasome, is basically a trash can that eats the toxic proteins made by the cell,” Smith says. “If you inhibit the proteasome you block the trash can. What you get as a result is an accumulation of these toxic proteins and the myeloma cells die.”5
Other targeted treatments work in concert with the body’s immune system. “In most people, cancers learn how to turn off the immune system so that (the body) can’t fight back,” says Smith. “But some of the most exciting drugs of the last few years harness the immune system, give it a jumpstart, or boost it so that the normal immune process, or an augmented immune process, can attack the myeloma.”4
Most importantly, multiple myeloma treatments appear to be effective when they are used in combination, providing doctors with an arsenal of treatment options that can be tailored to the specific needs of individual patients.5
“(With a combination therapy) you can combine several different drugs the way you would combine a navy, an army and an air force to win a war,” Smith says. “And because we have at least a dozen drugs now — and probably more in the next year or so — we have a lot of different combinations and a lot of ways we can pool all of these together to fight myeloma.”
He explains that “some [treatments] will target key features within the myeloma cell, like the proteasome, and combine those with other processes that boost the immune system to keep the myeloma from growing back.”5
Smith says that while multiple myeloma will remain a challenging disease, the future looks bright. “It’s not completely crazy to think that we’re going to be curing some people with myeloma within the next decade.”
References
1. Jakubowiak, A. Management strategies for relapsed/refractory multiple myeloma: Current clinical perspectives. Seminars in Hematology. 2012; 49(3)(1), S16-S31.
2. Rajkumar, SV & Moreau, P. Advances in biology and therapy. Nat. Rev. Clin. Oncol. 2014; 11, 628-630.
3. Kraj, M, et al. Long, even exceeding 20 years, survival in multiple myeloma. 15th Congress of the European Hematology Association. June 10-13, 2010; Barcelona, Spain. Abstract #0951.
4. Targeted therapy. American Cancer Society. 2016. Accessed on September 20, 2016. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003024-pdf.pdf.
5. Multiple myeloma. American Cancer Society. 2016. Accessed on September 20, 2016. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003121-pdf.pdf.
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