What`s new in multiple myeloma research and treatment?
Important research into multiple myeloma is being done in many university hospitals, medical centers, and other institutions around the world. Each year, scientists find out more about what causes the disease and how to improve treatment. Many new drugs are being tested.
Researchers have recently discovered that bone marrow-support tissues and bone cells produce growth factors that increase the growth of myeloma cells. In turn, the myeloma cells produce substances that cause bone cells to undergo changes that weaken the bones. These discoveries are helping the researchers develop new drugs to block these growth factors, slow down the cancer, and reduce bone destruction. For example, bone marrow stromal cells produce interleukin-6 (IL-6). Because IL-6 is a strong growth factor for multiple myeloma cells and eventually destroys bone, some current research efforts are focused on developing ways to block IL-6 function.
Another growth factor called RANKL has been discovered. It stimulates the cells responsible for dissolving bone. RANKL appears to be made in larger-than-normal amounts in the bone marrow of people with multiple myeloma. A drug called denosumab that blocks RANKL was studied in patients with multiple myeloma. Although early studies were promising, in later studies multiple myeloma patients treated with denosumab were more likely to die than those treated with bisphosphonates.
A form of arsenic, arsenic trioxide, is also being tested to treat myeloma.
Drugs that block blood vessel growth are also being studied in myeloma patients. Another type of drug being tested in myeloma blocks an important molecule in tumor growth called farnesyl transferase.
Research is also being directed toward improving transplants. A newer approach is to follow an autologous (self) transplant with an allogeneic one (donor). So far, results have been mixed, and more studies are needed.
An entirely new test called gene expression profiling has developed in the last several years. This test may be able to tell if and when a patient with multiple myeloma will need to have chemotherapy. Much more work lies ahead though, before this test can be used routinely.
Last Medical Review: 01/15/2013
Last Revised: 02/12/2013