New Therapies Bring Progress Against Multiple Myeloma

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.

23 thoughts on “New Therapies Bring Progress Against Multiple Myeloma”

  1. 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.

  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. 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.

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