Important research into multiple myeloma is underway in many university hospitals, medical centers, and other institutions around the country. 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 called stromal cells produce interleukin-6 (IL-6). Because IL-6 is a strong growth factor for multiple myeloma cells and eventually results in bone destruction, some current research efforts are focused on developing ways to block the function of IL-6.

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. Another natural substance called osteoprotegerin that blocks RANKL has also been discovered. Researchers are working to try and block bone destruction in this system, perhaps by giving patients osteoprotegerin. But first they have to learn how to make large quantities of this substance.

Research has shown that thalidomide is an effective drug in myeloma. But it causes major problems with sleepiness and nerve damage. New drugs, labeled ImiDs, have been developed that work like thalidomide but without its side effects. One of these, lenalidomide, has already been successful in clinical trials.

Another drug made from arsenic, arsenic trioxide, is also being considered to treat myeloma patients. So far it has only been effective in laboratory experiments, but clinical trials have begun.

A drug that blocks blood vessel growth is now being tested in myeloma patients. The drug, which attacks a molecule called VEGF, is called for now, PTK787/ZK222584. Drugs have been developed that block an important molecule in tumor growth called farnesyl transferase. Two such drugs, called farnesyl transferase inhibitors (FTI) are being tested in clinical trials of myeloma patients.

Much research is being directed toward improving transplants. An experimental approach is to follow an autologous (self) transplant with an allogeneic one (donor). Although results are promising, more studies are needed.

A new radioactive drug called 166Ho-DPTMP, which targets bone and bone marrow, is being tested as a preparatory step before stem cell transplant. Early results have been promising.

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 undergo intensive therapy. Much more work lies ahead though, before this test can be used routinely.

Revised: 08/04/2006