"The improvements are amazing," says Brion Randolph, MD, hematologist and chief of medical oncology at the Cancer Treatment Centers of America in Newnan, GA.
"I've already had a few patients I would've had to tell there were no options," he says. Now he says, the new meds are able to extend lives.
The Back Story
Until recently, doctors usually suggested chemotherapy drugs, which kill cancer cells but can also damage normal cells. The treatment has side effects, like fatigue and nausea. The goal is to put you in "remission" -- remove visible signs of the disease in your body.
In the 1990s and early 2000s, some promising new drugs appeared, including bortezomib (Velcade), lenalidomide (Revlimid), and thalidomide (Thalomid). They help prevent cancer cells from dividing out of control.
Doctors use combos of these drugs, sometimes adding in steroids, to help add years to the lives of people with multiple myeloma.
Treatment has changed in a big way with the arrival of new drugs that target the disease much more precisely. They're designed for people whose disease has returned or who haven't been able to get better with other treatments.
Daratumumab (Darzalex). You may hear your doctor call this a "monoclonal antibody." It puts the immune system -- your body's defense against germs -- to work in fighting multiple myeloma. It helps your body identify and attack cancer cells.
Elotuzumab (Empliciti). It's a drug that also uses your body's immune system to destroy multiple myeloma cells.
Ixazomib (Ninlaro). It's a type of drug called a "proteasome inhibitor." It interferes with the cancer cells' ability to grow and thrive inside your body. It comes with a built-in bonus: You don't need to a visit a clinic to get hooked up to an infusion machine. It's a once-a-week pill that you take at home.
Looking to the Future
Researchers are studying scores of new treatments that could be available down the road. Some especially encouraging possibilities:
Gene therapy. Researchers hope they'll be able to genetically tweak your body's immune cells to recognize and destroy multiple myeloma.
Gene expression profiling. It's a test that checks which genes are active in your cancer cells. Researchers are trying find a way to use it to figure out if -- and when -- you may need chemotherapy to treat your multiple myeloma.
Personalized drug screening. The idea is to quickly and accurately predict which treatments will be best for you. Researchers at Washington University in St. Louis, for example, are developing imaging procedures that will give you a personal treatment plan.
New drugs. Researchers are working to develop a medicine that blocks interleukin, a chemical that's made by the cells in your bone marrow -- the spongy tissue inside your bones that make blood cells. Interleukin helps multiple myeloma cells to grow.
Researches are also testing new combos of drugs already available to treat the disease. Sometimes the chemotherapy meds you take stop working. Doctors are checking to see if combining medicines will give you new treatment options.
New techniques in stem cell transplant. It's an operation that replaces cells in your bone marrow with new ones that make healthy blood cells. To treat multiple myeloma, doctors today mostly use a method that uses your own stem cells for the procedure. But researchers are checking to see if using a donor's stem cells can also help.
There's a lot of research still needed, but doctors are optimistic about the path forward. "More and more effective therapies are constantly being developed," Randolph says. "For multiple myeloma, the future is very hopeful."