New Therapies Bring Progress Against Multiple Myeloma

23

By Christine Cleary 

The 21st century has seen great strides in treatment for multiple myeloma, a cancer of the bone marrow once considered a death sentence. In fact, thanks to research by Dana-Farber scientists, this blood cancer that took the lives of Geraldine Ferraro and Leonard P. Zakim has become a chronic disease for many patients.

Ken Anderson, MD, and his colleagues have helped transform multiple myeloma into a more manageable illness by shepherding many novel drugs from the laboratory to the patient bedside.

Over a decade ago, median survival in multiple myeloma was just 2 to 3 years. Today, James (Jim) Bond of Cleveland, Ohio, who bicycles across his home state every year to raise money for cancer research, has been living with multiple myeloma for 20 years. Bond credits Dana-Farber’s clinical trials for his longevity.

Multiple myeloma leaders Paul Richardson, Nikhil Munshi, and Ken Anderson (left to right)

Multiple myeloma is estimated to strike 22,350 people in the U.S. in 2013. Although there is still no cure, Dana-Farber researchers have contributed to the following advances.

  • Velcade. In 2003, the FDA approved a drug called bortezomib (Velcade), which today is standard treatment for newly diagnosed myeloma, thanks to research conducted by Anderson, Paul Richardson, MD, and their colleagues at Harvard Medical School and elsewhere.
  • Studying the tumor’s “neighborhood.” Around the time that Velcade was approved, Anderson and his team were also investigating the drug thalidomide (Thalomid) as a treatment for myeloma. They explored the effect of medications not just on the tumor cells but also on those surrounding the tumor, including non-cancerous immune and other cells.
  • Thalidomide, Revlimid and Pomalidomide. Anderson and his team discovered that thalidomide and its close cousin lenalidomide (Revlimid) actively recruit immune cells to fight cancer. Clinical trials led by Richardson and colleagues set the stage for the approval of lenalidomide to treat advanced myeloma in 2006. The most potent immunomodulator studied by both the laboratory and clinical team to date, called pomalidomide (Pomalyst), was approved in February 2013.
  • Combination drugs. Because many genetic mutations drive a single tumor, cancer is often best treated with combinations of therapies. Dana-Farber researchers hope to personalize multiple myeloma treatment by categorizing patients based on the molecular pathways that drive their cancer, and prescribe the appropriate combinations of drugs.
  • Stem cell transplant. This procedure is still a key component of treatment for multiple myeloma.  DF/BWCC is a leading provider of stem cell transplantation, which involves giving the patient healthy bone marrow harvested from his or her own stem cells, or sometimes those of a donor.
  • Clinical research. Multiple clinical trials at Dana-Farber are open for multiple myeloma patients in various settings. In particular, Richardson and his colleagues have launched a large trial, in collaboration with other medical centers, to test a combination of the drugs lenalidomide, bortezomib, and dexamethasone. Sophisticated testing of myeloma genetics in each patient (led by Nikhil Munshi, MD ) is an integral part of this trial and will hopefully facilitate a highly tailored approach to treatment in the future.
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23 thoughts on “New Therapies Bring Progress Against Multiple Myeloma

  1. Dear Donna —

    We are so sorry to hear about your health trouble. Unfortunately, we cannot give out medical advice on this blog or over email, and it would be best to consult with your doctor or care team with the questions you have.

    If you are interested in seeking a second opinion here at Dana-Farber, the procedure is the same as for becoming a new patient. If you are able to come to Boston to meet with our treatment team, please call 877-442-DFCI (877-442-3324) or fill out this online appointment request form:
    https://www.dana-farber.org/apps/request-an-appointment.aspx

    If you are not able to travel to Boston, Dana-Farber offers a program called Online Specialty Consults, which allows patients and physicians to confer with our specialists online about second opinions, treatment options, or clinical trials.

    You will need to involve your local physician, who will register with the service and complete a patient history. One of our specialists, who will be chosen depending on your particular medical background, will review your case and then send a consultation report back to your physician.

    These links provide an overview of the process:
    http://www.dana-farber.org/Partners-Online-Specialty-Consultations.aspx
    https://econsults.partners.org/v2/%28jwewk42ud2zpsevdo4p1l545%29/Tour/1.html

    I hope this is helpful. Wishing you all the best.

  2. Can anyone help me please? I have had a low white count and neutrophils since 2006 with no symptoms, healthy, workout regularly. Finally I had a bone marrow biopsy in June 2012 and another in July 2013. They were not looking for multiple myeloma, they were ruling out MDS and leukemia, it was negative. I go for routine blood test to follow up on my counts, other than a slight decrease in WBC’s and neutrophils all else is good. I went this past week and my new Hematologist at Stanford had my bone marrow biopsy that was done in 2012 reviewed by their Pathologist and it came back with the marrow showing increase plasma cells abnormal morphology highly suspicious for a plasma cell neoplasm. This was not caught on the reading in 2012 or 2013. Everything I have been reading indicates multiple myeloma. Does increase plasma cells abnormal morphology make it a certain diagnosis or do other test have to be done? Of course it’s the weekend and I can’t talk to my doctor and I am naturally concerned. I’ve read increase plasma cells that are abnormal morphology means multiple myeloma, is that correct or am I not understanding it? Would greatly appreciate any insight.
    Thank you

  3. My sister has MM and was also diagnosed with breast cancer – her masectomy was successful but her amaloids have affected her heart. The main problem she suffers from is a ‘pressure’ on her upper face affecting her eyes, forehead and nose. Has anyone else had this, if so do you know what causes it and is there anything that can help. No apparent support or diagnosis for this sympton here in the UK. It stops my sister from doing lots of ‘normal’ activities. Hope someone can shed a light on this.

  4. If my 70 gene expression score is negative -0.25, what does this mean? Is it good or bad? I thought the scores only went from 1-100. Thanks

  5. My father is admitted right now with multiple myeloma, diagnosed approx 4yrs ago at Chrstus-Schumpher Hospital in Shreport Louisiana. They may need your help. W Loftin. Thanks

  6. My husband Lenny was diagnosed 8/13/2010. He had a t-2 fracture and a large at the same location in his spine. He had 23 radiation treatments which resulted in paraplegia from the bony fragments that fell into his spine. In March of 2011 he started to move his toes! In May 2011 he had surgery at Stamford Medical Center. He began to walk again in August 2011 with a walker. We moved back to NY from Florida in January of 2012. Lenny was on Revlimid, Velade, Velcade sub-q for several months but there was too many side effects-PN, sweats, etc. He continues to have leg spasms, stiffness and constant pain 24/7 and is very weak. He takes Boost Hi-Protein, but doesn’t have an appetite. He takes Relistor because of the opiates. Can you recommend anything to give him more strength? A good diet? He cannot take cur cumin, l-glutamine, green tea extract, causes bloating.

    • Dear Elizabeth,

      Thank you for your comment. I’m sorry to hear of your husband Lenny’s challenges. Questions like the ones you ask are very important ones to bring up with his oncologist. Unfortunately, we can’t give out medical advice over email (or via this blog). You might request a second opinion from Dana-Farber. Or you could consider joining CancerConnect, a secure online community where patients share stories and tips. Through this community you might benefit from another patient’s experience managing multiple myeloma. Similarly, if your oncologist wants to talk to one of our multiple myeloma doctors, that is also possible.

      With very best wishes to you and your husband.

  7. I was wondering if anyone has developed shingles while being treated for MM. My sister had the shot a few years back but because of the low resistance, she is in terrible nerve pain from the shingles. Her back pain is unbearable from the MM.

    I do not understand why they cannot help her with the shingles….

    Thanks

  8. I’m a patient of Dr. Richardson’s and I want to thank him, his team, and all the others in the MM group at Dana Farber. I think they are the best: always caring, professional, and pushing the limits of knowledge about this disease. These are the people who get the research results to real patients as soon as possible, and listen carefully to those patients so they can feed back information to the research people. Again, thank you for all you are doing!

  9. I was diagnosed with MM in August, 2012. It’s essentially one year later and I have gone through 8 cycles of RVD and an auto-stem cell transplant @ the Brigham. My strength, stamina are coming back…and I will be participating in a trial at DFCI. I am optimistic and encouraged by all the good work done by Dr. Richardson and the rest of the international MM research community! I’m 62 now and looking forward to 2-3 more decades of quality life. Congratulations, Dr. Richardson and team on the great progress you have made; I hope my personal participation in trials and donations to DFCI can contribute to further success.

  10. My Mom, age 74, was diagnosed in May of 2006 and lost her life in Jan of 2007. MM was very painful not only in the growth of the tumors but the treatment. She was treated with Thalidomide and Dexadron and radiation. The side effects were depilating. I thank God that HE limited her time of suffering and carried her the rest of the way. I have 2 brothers and always wonder if this is a cancer we should be concerned about in our health.

    I appreciate your constant research and never ending determination in the cure and treatment of this awful disease.

  11. My name is Mike Thorn and I have been Blessed with MM since March 2002 and I’m still going strong. My prayers go out to those that have lost their loved ones and to those families living as the caregivers for current patients battling MM. I am not treated at Dana-Faber, protocol being driven by the Myeloma center in Little Rock Arkansas, but want to thank all of the major MM centers that contribute to the battle against this disease. I was stage 3 Igg Kappa and had a relapse in Oct/2010 and the drugs of Revlimid & Velcade along with Dex have gotten this relapse under control. Velcade has been the most successful drug for me.

    So thanks DF for your continued battle against this Cancer.

    rgs Mike

  12. My Husband Chuck was diagnosed Feb 2012 with stage 3 Multiple Myeloma, he passed September 2012. It is my hope that something helps others to survive this deadly disease. Revlimid and the other conventional chemotherapy did not help my husband. He was only 57 years old.

    • Dear Barbara,
      We are very sorry to hear of the loss of your husband at such a young age. In his honor our scientists will continue to push the research forward. You might benefit from Dana-Farber’s bereavement resources. Best wishes to you and your family.

  13. Dr Munshi and his colleagues are and always be in my heart for the care concern and love they all showed my husband David during his four year battle with multiple myeloma. I know that what they learned from David will save someone’s life in the future. Bless you all for what you do every day! Susan

  14. My wife was diagnosed with asymptomatic MM in 2006. Various medicines have kept it under control. Right now she is on Pomalyst and Dex and is having bad side effects from the Pom-mainly constipation and severe stomach ache. Has anyone else had such a reaction to Pomalyst? Where did you go from there?

  15. My husband Robert is a patient at Dana-Farber under Dr Laubach. He has Multiple Myeloma and will be harvesting (autologous) stem cells staring 07/29/2013. Dr Jacob Laubach @ Dana-Farber, Dr Preshant Shankar now @ Newton-Wellesley and Dr Christine Wasilewski @ Portsmouth NH all work together to give my husband the best care he could ever have. I pray to have Robert around for many many more years.
    thank-you
    Cecile Poliquin

  16. My father was diagnosed with Multiple Myeloma in June 2008 and died in April of 2012. I wish more than anything he was lucky enough to be the example of living 20 years with the disease discussed in the article. Dana Farber gave my father the time he did have and I am lucky it was as long as it was, but this post is difficult to read knowing my father was not fortunate enough to have his time be much longer than the previous survival rates. I have an aunt who was diagnosed shortly after my father passed, though, and her prognosis has been much better.

    • Dear Caitlin,
      We are very sorry to hear of the loss of your father. His experience reminds us that there is more work to be done on the multiple myeloma front. You might benefit from Dana-Farber’s bereavement resources. Best wishes to you and your family.

    • My husband was diagnosed with Mutiple Myeloma in 1996 and he passed away January of 2008 I also which he was lucky enough to be the example of living 20 years.

    • Dea Caitlin:

      I lost my mother in January, 2007 to the disease and I absolutely sympathize with your regrets. My mother was discovered quite late in the process and down in Florida where some doctors and care can be considered suspicious at best. However, I do know that she would be pleased to see such progress being made so that other good, decent people will have a better shot at a productive life than she did. That’s just who she was and I’m sure who your father was. My thoughts are with you.

  17. My husband Lenny was diagnosed 8/13/2010. He had a t-2 fracture and a large at the same location in his spine. He had 23 radiation treatments which resulted in paraplegia from the bony fragments that fell into his spine. In March of 2011 he started to move his toes! In May 2011 he had surgery at Stamford Medical Center. He began to walk again in August 2011 with a walker. We moved back to NY from Florida in January of 2012. Lenny was on Revlimid, Velade, Velcade sub-q for several months but there was too many side effects-PN, sweats, etc. He continues to have leg spasms, stiffness and constant pain 24/7 and is very weak. He takes Boost Hi-Protein, but doesn’t have an appetite. He takes Relistor because of the opiates. Can you recommend anything to give him more strength? A good diet? He cannot take cur cumin, l-glutamine, green tea extract, causes bloating.

    1. Dear Elizabeth,

      Thank you for your comment. I’m sorry to hear of your husband Lenny’s challenges. Questions like the ones you ask are very important ones to bring up with his oncologist. Unfortunately, we can’t give out medical advice over email (or via this blog). You might request a second opinion from Dana-Farber. Or you could consider joining CancerConnect, a secure online community where patients share stories and tips. Through this community you might benefit from another patient’s experience managing multiple myeloma. Similarly, if your oncologist wants to talk to one of our multiple myeloma doctors, that is also possible.

      With very best wishes to you and your husband.

  18. I was wondering if anyone has developed shingles while being treated for MM. My sister had the shot a few years back but because of the low resistance, she is in terrible nerve pain from the shingles. Her back pain is unbearable from the MM.

    I do not understand why they cannot help her with the shingles….

    Thanks

  19. I’m a patient of Dr. Richardson’s and I want to thank him, his team, and all the others in the MM group at Dana Farber. I think they are the best: always caring, professional, and pushing the limits of knowledge about this disease. These are the people who get the research results to real patients as soon as possible, and listen carefully to those patients so they can feed back information to the research people. Again, thank you for all you are doing!

  20. My father is admitted right now with multiple myeloma, diagnosed approx 4yrs ago at Chrstus-Schumpher Hospital in Shreport Louisiana. They may need your help. W Loftin. Thanks

  21. Dear Donna —

    We are so sorry to hear about your health trouble. Unfortunately, we cannot give out medical advice on this blog or over email, and it would be best to consult with your doctor or care team with the questions you have.

    If you are interested in seeking a second opinion here at Dana-Farber, the procedure is the same as for becoming a new patient. If you are able to come to Boston to meet with our treatment team, please call 877-442-DFCI (877-442-3324) or fill out this online appointment request form:
    https://www.dana-farber.org/apps/request-an-appointment.aspx

    If you are not able to travel to Boston, Dana-Farber offers a program called Online Specialty Consults, which allows patients and physicians to confer with our specialists online about second opinions, treatment options, or clinical trials.

    You will need to involve your local physician, who will register with the service and complete a patient history. One of our specialists, who will be chosen depending on your particular medical background, will review your case and then send a consultation report back to your physician.

    These links provide an overview of the process:
    http://www.dana-farber.org/Partners-Online-Specialty-Consultations.aspx
    https://econsults.partners.org/v2/%28jwewk42ud2zpsevdo4p1l545%29/Tour/1.html

    I hope this is helpful. Wishing you all the best.

  22. Can anyone help me please? I have had a low white count and neutrophils since 2006 with no symptoms, healthy, workout regularly. Finally I had a bone marrow biopsy in June 2012 and another in July 2013. They were not looking for multiple myeloma, they were ruling out MDS and leukemia, it was negative. I go for routine blood test to follow up on my counts, other than a slight decrease in WBC’s and neutrophils all else is good. I went this past week and my new Hematologist at Stanford had my bone marrow biopsy that was done in 2012 reviewed by their Pathologist and it came back with the marrow showing increase plasma cells abnormal morphology highly suspicious for a plasma cell neoplasm. This was not caught on the reading in 2012 or 2013. Everything I have been reading indicates multiple myeloma. Does increase plasma cells abnormal morphology make it a certain diagnosis or do other test have to be done? Of course it’s the weekend and I can’t talk to my doctor and I am naturally concerned. I’ve read increase plasma cells that are abnormal morphology means multiple myeloma, is that correct or am I not understanding it? Would greatly appreciate any insight.
    Thank you

  23. My sister has MM and was also diagnosed with breast cancer – her masectomy was successful but her amaloids have affected her heart. The main problem she suffers from is a ‘pressure’ on her upper face affecting her eyes, forehead and nose. Has anyone else had this, if so do you know what causes it and is there anything that can help. No apparent support or diagnosis for this sympton here in the UK. It stops my sister from doing lots of ‘normal’ activities. Hope someone can shed a light on this.

  24. If my 70 gene expression score is negative -0.25, what does this mean? Is it good or bad? I thought the scores only went from 1-100. Thanks

  25. I was diagnosed with MM in August, 2012. It’s essentially one year later and I have gone through 8 cycles of RVD and an auto-stem cell transplant @ the Brigham. My strength, stamina are coming back…and I will be participating in a trial at DFCI. I am optimistic and encouraged by all the good work done by Dr. Richardson and the rest of the international MM research community! I’m 62 now and looking forward to 2-3 more decades of quality life. Congratulations, Dr. Richardson and team on the great progress you have made; I hope my personal participation in trials and donations to DFCI can contribute to further success.

  26. My Mom, age 74, was diagnosed in May of 2006 and lost her life in Jan of 2007. MM was very painful not only in the growth of the tumors but the treatment. She was treated with Thalidomide and Dexadron and radiation. The side effects were depilating. I thank God that HE limited her time of suffering and carried her the rest of the way. I have 2 brothers and always wonder if this is a cancer we should be concerned about in our health.

    I appreciate your constant research and never ending determination in the cure and treatment of this awful disease.

  27. My husband Robert is a patient at Dana-Farber under Dr Laubach. He has Multiple Myeloma and will be harvesting (autologous) stem cells staring 07/29/2013. Dr Jacob Laubach @ Dana-Farber, Dr Preshant Shankar now @ Newton-Wellesley and Dr Christine Wasilewski @ Portsmouth NH all work together to give my husband the best care he could ever have. I pray to have Robert around for many many more years.
    thank-you
    Cecile Poliquin

  28. My wife was diagnosed with asymptomatic MM in 2006. Various medicines have kept it under control. Right now she is on Pomalyst and Dex and is having bad side effects from the Pom-mainly constipation and severe stomach ache. Has anyone else had such a reaction to Pomalyst? Where did you go from there?

  29. My name is Mike Thorn and I have been Blessed with MM since March 2002 and I’m still going strong. My prayers go out to those that have lost their loved ones and to those families living as the caregivers for current patients battling MM. I am not treated at Dana-Faber, protocol being driven by the Myeloma center in Little Rock Arkansas, but want to thank all of the major MM centers that contribute to the battle against this disease. I was stage 3 Igg Kappa and had a relapse in Oct/2010 and the drugs of Revlimid & Velcade along with Dex have gotten this relapse under control. Velcade has been the most successful drug for me.

    So thanks DF for your continued battle against this Cancer.

    rgs Mike

  30. My Husband Chuck was diagnosed Feb 2012 with stage 3 Multiple Myeloma, he passed September 2012. It is my hope that something helps others to survive this deadly disease. Revlimid and the other conventional chemotherapy did not help my husband. He was only 57 years old.

    1. Dear Barbara,
      We are very sorry to hear of the loss of your husband at such a young age. In his honor our scientists will continue to push the research forward. You might benefit from Dana-Farber’s bereavement resources. Best wishes to you and your family.

  31. Dr Munshi and his colleagues are and always be in my heart for the care concern and love they all showed my husband David during his four year battle with multiple myeloma. I know that what they learned from David will save someone’s life in the future. Bless you all for what you do every day! Susan

  32. My father was diagnosed with Multiple Myeloma in June 2008 and died in April of 2012. I wish more than anything he was lucky enough to be the example of living 20 years with the disease discussed in the article. Dana Farber gave my father the time he did have and I am lucky it was as long as it was, but this post is difficult to read knowing my father was not fortunate enough to have his time be much longer than the previous survival rates. I have an aunt who was diagnosed shortly after my father passed, though, and her prognosis has been much better.

    1. Dea Caitlin:

      I lost my mother in January, 2007 to the disease and I absolutely sympathize with your regrets. My mother was discovered quite late in the process and down in Florida where some doctors and care can be considered suspicious at best. However, I do know that she would be pleased to see such progress being made so that other good, decent people will have a better shot at a productive life than she did. That’s just who she was and I’m sure who your father was. My thoughts are with you.

    2. My husband was diagnosed with Mutiple Myeloma in 1996 and he passed away January of 2008 I also which he was lucky enough to be the example of living 20 years.

    3. Dear Caitlin,
      We are very sorry to hear of the loss of your father. His experience reminds us that there is more work to be done on the multiple myeloma front. You might benefit from Dana-Farber’s bereavement resources. Best wishes to you and your family.

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