Multiple Myeloma Advances: Noted Hematologist Envisions Big Changes in Treatment Paradigms -
Clinicians who treat patients with multiple myeloma have witnessed a sea change in the past 15 years. Yet another revolution appears right around the corner, with emerging monoclonal antibodies generating promising results in clinical trials and research on risk stratification revealing how to identify which patients should be treated early, according to Jesús F. San Miguel, MD, PhD.
How to attack and paralyze myeloma cells
Multiple Myeloma is one of the most common blood cancers, mainly diagnosed in elderly patients. As life expectancy increases, the frequency of the disease has therefore increased during the last decades. Both deeper insights into disease biology including interactions between malignant plasma cells and their bone marrow environment, and the design and clinical testing of new drugs have led to a considerable improvement in the prognosis of this mostly incurable disease during the last years. The right timing and the choice of the best treatment match for the particular myeloma stage and the needs of the individual patient are essential for optimal disease control.
Researchers turn clinical experience in multiple myeloma treatment into instructive review for physicians
Multiple myeloma is a malignant disease characterised by proliferation of clonal plasma cells in the bone marrow and typically accompanied by the secretion of monoclonal immunoglobulins that are detectable in the serum or urine. Increased understanding of the microenvironmental interactions between malignant plasma cells and the bone marrow niche, and their role in disease progression and acquisition of therapy resistance, has helped the development of novel therapeutic drugs for use in combination with cytostatic therapy. Together with autologous stem cell transplantation and advances in supportive care, the use of novel drugs such as proteasome inhibitors and immunomodulatory drugs has increased response rates and survival substantially in the past several years. Present clinical research focuses on the balance between treatment efficacy and quality of life, the optimum sequencing of treatment options, the question of long-term remission and potential cure by multimodal treatment, the pre-emptive treatment of high-risk smouldering myeloma, and the role of maintenance. Upcoming results of ongoing clinical trials, together with a pipeline of promising new treatments, raise the hope for continuous improvements in the prognosis of patients with myeloma in the future.