What is the best treatment for multiple myeloma?
In the past decade, many new agents in various drug classes have become available and effective in the treatment of multiple myeloma. Ideally, your frontline therapy (also called induction or first-line therapy) should
Which drugs generate deep responses in multiple myeloma?
For example, in a single-arm phase II trial, Dr. Kazandjian and his colleagues found that treatment with lenalidomide, dexamethasone, and carfilzomib (Kyprolis®) generated deep responses in patients with newly diagnosed multiple myeloma.
What are the side effects of multiple myeloma treatment?
It may be especially helpful in treating myeloma patients with kidney problems. It’s injected into a vein (IV) or under the skin, once or twice a week. Common side effects of this drug include nausea and vomiting, tiredness, diarrhea, constipation, fever, decreased appetite, and lowered blood counts.
What are protein inhibitors for multiple myeloma?
Proteasome inhibitors are a staple of multiple myeloma treatment and are used throughout all stages of disease. Proteasomes are protein complexes that help cells — including cancer cells — dispose of old proteins so they can be replaced by newer versions. Proteasome inhibitors are drugs that prevent cancer cells from doing this.
What is the latest treatment for myeloma?
The latest approval is for the combination of daratumumab plus hyaluronidase-fijh (Darzalex Faspro) plus carfilzomib (Kyprolis) and the steroid dexamethasone for the treatment of adults with relapsed or refractory multiple myeloma who received one to three prior treatments.
How successful is myeloma treatment?
Myeloma is not usually curable but treatment can control it. You usually have treatment for four to six months. Then if you are fit enough, your specialist might suggest intensive treatment using high dose chemotherapy with a stem cell transplant.
What are the side effects of chemotherapy for myeloma?
Some chemotherapy drugs can cause side effects, such as feeling sick (nausea), fatigue, loss of hair from the body and head, a drop in blood count, mouth sores, diarrhoea and a weakened immune system. These side effects are temporary and there are ways to prevent or reduce them.
What are the side effects of immunotherapy for multiple myeloma?
Side effects common to many of these drugs include appetite changes, diarrhea, fatigue, fever, infection, hair loss, memory problems, mouth and throat sores, and nausea and vomiting.
Can you live a normal life with myeloma?
Apart from ongoing monitoring, most myeloma patients are able to live fairly normal lives, with few restrictions on low-impact exercise and other activity.
Is myeloma a death sentence?
Today, a multiple myeloma diagnosis is no longer a death sentence because our community's efforts have helped bring 11 new drugs through FDA-approval.
Do you lose your hair with chemo for myeloma?
Side effects of chemo Chemo can have many side effects, like: Hair loss. Mouth sores. Not feeling like eating.
Does treatment for multiple myeloma make you sick?
Meds like bortezomib (Velcade), carfilzomib (Kyprolis), and ixazomib (Ninlaro) can cause constipation, diarrhea, nausea, or vomiting. Other chemotherapy drugs, bisphosphonates, and radiation treatments can make you queasy or throw up. Steroids may also make your stomach upset.
What is life expectancy with multiple myeloma?
Multiple myeloma is an uncommon cancer of the blood. The median length of survival after diagnosis with multiple myeloma is 62 months for Stage I, 44 months for Stage II, and 29 months for Stage III. Life expectancy depends on many factors, including the person's age, health, kidney function, and more.
What are the dangers of immunotherapy?
There are side effects. Some types of immunotherapy rev up your immune system and make you feel like you have the flu, complete with fever, chills, and fatigue. Others could cause problems like swelling, weight gain from extra fluids, heart palpitations, a stuffy head, and diarrhea.
Which is better immunotherapy or chemotherapy?
Chemotherapy kills fast-growing cells—both cancerous and non-cancerous—in the body. Immunotherapy helps the immune system do a better job of identifying cancer cells so it can attack and kill them.
Is immunotherapy a last resort?
Immunotherapy is still proving itself. It's often used as a last resort, once other therapies have reached the end of their effectiveness.
What is the treatment for multiple myeloma?
Chemotherapy. Chemotherapy (chemo) is the use of certain kinds of drugs that destroy or control the growth of cancer cells. These drugs can be taken by mouth or given in a vein or a muscle. They enter the bloodstream and reach almost all areas of the body. At one time, chemo was often part of the main treatment for multiple myeloma.
How many different drugs are used for multiple myeloma?
Although a single drug may be used to treat multiple myeloma, it is preferable to use at least 2 or 3 different kinds of drugs in combination because the cancer responds better. For example:
What is Daratumumab used for?
This is thought to both kill the cancer cells directly and to help the immune system attack them. This drug is used mainly in combination with other types of drugs, although it can also be used by itself in patients who have already had several other treatments for their myeloma.
What is the antibody that kills myeloma cells?
Isatuximab (Sarclisa) is another monoclonal antibody that attaches to the CD38 protein on myeloma cells. This is thought to both kill the cancer cells directly and to help the immune system attack them. This drug is used along with other types of myeloma drugs, typically after at least 2 other treatments have been tried. It’s given as an infusion into a vein (IV).
What antibody is used to fight SLAMF7?
Antibodies against SLAMF7. Elotuzumab (Empliciti) is a monoclonal antibody that attaches to the SLAMF7 protein, which is found on myeloma cells. This is thought to help the immune system attack the cancer cells. This drug is used mainly in patients who have already had other treatments for their myeloma.
What are the side effects of thalidomide?
Side effects of thalidomide can include drowsiness, fatigue, severe constipation, and painful nerve damage ( neuropathy ).
Can lenalidomide cause nerve damage?
It can also cause painful nerve damage. The risk of blood clots is not as high as that seen with thalidomide, but it is still increased. In patients, where the myeloma is in remission after either a stem cell transplant or initial treatment, lenalidomide may be given for maintenance therapy to prolong the remission.
What are the best treatments for multiple myeloma?
These include proteasome inhibitors, immune-modulating drugs, and chemotherapies. Two, three, or four drugs can be combined to get the best results.
What is the treatment for myeloma?
Most people with myeloma first have intensive treatment to lessen the disease. This is called induction treatment. It often includes a combination of drugs and high-dose chemotherapy. When needed, those are followed by autologous stem cell transplantation (in which your own stem cells are used).
What is the drug that blocks the proteasome?
Bortezomib blocks that activity, which is why this type of drug is called a proteasome inhibitor. It causes defective proteins to build up and die. Myeloma cells seem to be more sensitive than normal cells to this effect, although some healthy cells can be harmed.
What is the most common immune modifying drug?
Lenalidomide is the most common immune-modifying drug. It is included in most initial treatments and also for maintenance. Pomalidomide (Pomalyst ®) is the most recent immune-modifying drug approved for people with multiple myeloma. It can be effective when lenalidomide and other drugs stop working.
Is lenalidomide a form of thalidomide?
Thalidomide is also given to people with multiple myeloma if the disease comes back. Lenalidomide is a more potent form of thalidomide.
What are the three drugs that are used to treat multiple myeloma?
Our doctors use three immune-modifying drugs to treat multiple myeloma: thalidomide, lenalidomide, or pomalidomide.
Is carfilzomib a first line treatment?
At MSK, carfilzomib is often used as first-line therapy in combination with lenalidomide and dexamethasone for people who can tolera te this combination. Carfilzomib can be effective when bortezomib or other treatments have proven ineffective, or when multiple myeloma has returned after an earlier treatment.
Which steroid is used to treat multiple myeloma?
These studies suggest that the particular combination of a proteasome inhibitor (like bortezomib or carfilzomib), an immunomodulating agent (like lenalidomide) and a steroid (like dexamethasone) may have enhanced activity against multiple myeloma, said Dr. Kazandjian.
What drugs are used for multiple myelom?
For example, in a single-arm phase II trial, Dr. Kazandjian and his colleagues found that treatment with lenalidomide, dexamethasone, and carfilzomib (Kyprolis ®) generated deep responses in patients with newly diagnosed multiple myeloma. And an ongoing phase III trial is comparing outcomes of patients treated with lenalidomide and dexamethasone plus either carfilzomib or bortezomib.
How many patients were enrolled in the Cedars Sinai trial?
The open-label trial, led by Brian G. M. Durie, M.D., of the Cedars-Sinai Samuel Oschin Cancer Center, enrolled 525 patients with multiple myeloma who had not received previous cancer treatment and who did not plan to immediately have a stem cell transplant. Patients were randomly assigned to receive the three-drug combination in eight 3-week ...
Why delay transplant?
But some transplant-eligible patients may opt to delay the procedure because of its potential toxicity and the risk of developing a second primary cancer, especially when highly efficacious drug regimens are becoming another option, explained Dr. Kazandjian. Previous early-stage clinical trials demonstrated the safety and efficacy ...
Can bortezomib be used for multiple myeloma?
For newly diagnosed patients with multiple myeloma who plan to delay autologous stem cell transplantation, adding the targeted therapy bortezomib (Velcade®) to a two-drug therapy improves how long they live compared with the doublet therapy alone, a new study has shown.
Can multiple myeloma patients have stem cells?
As part of first-line therapy, some patients with multiple myeloma may undergo a stem cell transplant. But because the procedure is time consuming and may cause serious side effects, patients may opt to delay it or to not have one at all. For patients who don’t intend to have a stem cell transplant immediately after diagnosis, ...
Does Bortezomib block proteasomes?
Bortezomib blocks the action of the proteasome (pictured above), a cellular complex that eliminates and recycles proteins that are damaged or no longer needed. For newly diagnosed patients with multiple myeloma who plan to delay autologous stem cell transplantation, adding the targeted therapy bortezomib ...
What is the best treatment for myeloma?
Common combinations that we use are things like Revlimid® plus dexamethasone , or Velcade®, Revlimid, and dex. Many combinations of the most active therapies used for myeloma treatment include that dexamethasone.
How do steroids help myeloma?
The use of steroids improves the effectiveness of myeloma therapies. Consider reducing the steroid dose or stopping the use of steroids once a desirable outcome has been achieved. Discuss the use of steroids carefully with your doctor.
Should steroids be reduced?
Whenever there is a chance, and if it’s feasible, steroid dosage should be reduced. If feasible, even stopped, if an excellent response has been achieved. The BOTTOM LINE, in this case, is that you can see clearly that the use of steroids is something to discuss very carefully with your doctor.
How to help people with multiple myeloma?
Tai chi and yoga are both gentle forms of exercise that may benefit people with multiple myeloma. Tai chi combines flowing movements with focused breathing. Yoga moves you through a series of poses. Research shows that both of these could reduce stress and anxiety, ease pain and fatigue, and improve sleep in people who have cancer.
How to help myeloma pain?
Massage therapy can relieve muscle pain and help you relax. Tell your massage therapist you have multiple myeloma and to use light touch to protect your bones, which may be weak.
What is complementary medicine?
The term “complementary and alternative medicine ” refers to treatments that are not part of standard medical care. They can include massage, acupuncture, tai chi, and herbal remedies. There’s some overlap between this term and naturopathy, homeopathy, and holistic medicine.
Does multiple myeloma have vitamin D?
People with multiple myeloma often have low levels of vitamin D. Healthy levels of this vitamin can protect you from bone complications that are common in this type of blood cancer.
Can multiple myeloma cause constipation?
Multiple myeloma and the treatments for it can cause pain, fatigue, constipation, loss of appetite, and other unpleasant symptoms. Complementary and alternative treatments may help you relieve these symptoms or ease the stress of living with cancer.
Can you have complementary treatments for multiple myeloma?
Before you try any complementary treatments for multiple myeloma, talk to your oncologist . They can tell you whether the therapy is safe for you, if it will interact with your cancer treatments, and if it’s likely to be effective.
Does acupuncture help with myeloma?
One study showed that acupuncture may help control nausea, appetite loss, and drowsiness and reduce the need for pain medicine after a stem cell transplant, a common myeloma treatment.
Does dexamethasone work better with bortezomib?
Dexamethasone allows us to have synergy between those drugs, the bortezomib (Velcade), the lenalidomide (Revlimid), things like that. And we know that all of these regimens work better with steroids on board. That being said, I can't think of anybody who loves taking 40 milligrams of dexamethasone.
Is dexamethasone good for myeloma?
Dexamethasone (Decadron) is a steroid, and it's a very effective drug against many immune cells. And myeloma is a cancer of immune cells, and so that' s why we use dexamethasone to treat myeloma. Now, there was a time where that was one of the most important drugs and one of the most used drugs, and I should say, one of the most effective drugs.
How to treat multiple myeloma?
Steroids. Steroids are a staple of multiple myeloma treatment and are used at all stages of the disease. In high doses, steroids can kill multiple myeloma cells. They can also decrease inflammation by stopping white blood cells from flowing to the disease-affected areas, helping relieve pain and pressure.
What are the best drugs for multiple myeloma?
The main types of drug therapies used to treat multiple myeloma are proteasome inhibitors, immunomodulatory drugs (IMiDs), steroids, histone deacetylase (HDAC) inhibitors, antibodies and chemotherapy. Each works in a different way, but with the common goal of controlling and destroying multiple myeloma cells.
What is monoclonal antibody?
Monoclonal antibodies are a type of immunotherapy. These drugs enhance the cancer-fighting abilities of a patient’s own immune system by introducing antibodies into the body that target specific proteins found on multiple myeloma cells.
What is the mainstay of the immunotherapy regimen used to treat multiple myeloma?
Immunomodulatory drugs (IMiDs) This class of immunotherapy drugs is the mainstay of standard regimens used to treat multiple myeloma. IMiDs work by regulating certain aspects of the immune system. They can activate certain immune cells, prevent certain types of growth signals for cancer cells and directly kill myeloma cells.
Do steroids affect the immune system?
Over time, steroids may suppress the immune system and weaken bones. These side effects usually go away after patients stop taking these drugs.
Can you give Velcade to someone who has already received Velcade?
Velcade is often given in combination with other drugs and can be given to patients who have previously received Velcade. Kyprolis (carfilzomib) An IV drug (used either in combination or alone) given to patients who have previously received at least one other treatment for multiple myeloma.
Can you donate to a myeloma patient?
You can help accelerate a cure for each and every myeloma patient. Click to explore ways that you can donate.
