Advances In Medicine In The Search For An Operational Cure For Multiple Myeloma

Advances In Medicine In The Search For An Operational Cure For Multiple Myeloma

Multiple myeloma, the most common type of plasma cell tumor, arises in the bone marrow and can spread throughout the body.

Normal plasma cells are found in the bone marrow and are an important component of the immune system. Photo: Shutterstock.

This is a cancer of the plasma cells, they are white blood cells that produce antibodies that protect us from infections, when a patient develops this condition it is because these cells multiply too much and displace the normal cells found in the bone marrow and that produce red blood cells, platelets, and other white blood cells.


Prevalence of multiple myeloma and your diagnosis

This type of cancer is rare. In the United States alone, the lifetime risk of developing multiple myeloma is 1 in 132 (0.76% chance).

By the year 2022, estimates from the American Cancer Society for this cancer in the United States, it is expected to increase to 34,470 new cases of multiple myeloma, of which 19,100 are men and 15,370 women. About 12,640 people, including 7,090 men and 5,550 women, would die from this disease.

Advances in science against the treatment of multiple myeloma

Researchers from the Spanish Myeloma Group, GEM-PETHEMA, have carried out the phase III clinical study called GEM12menos65, which they presented at the 19th Meeting of the International Myeloma Society, in which they advance towards the operational cure of multiple myeloma.

In this study, carried out in patients with newly diagnosed multiple myeloma treated with VRD chemotherapy before and after an autologous transplant, it was shown that Progression-Free Survival (PFS) of 80 months was achieved, which is the best PFS ever reported, surpassing the 67 months that constituted the previous reference.

This trial, which began in 2013 in newly diagnosed transplant-eligible patients (those under 65 years of age), included a total of 458 patients.

The trial was designed to compare the clinical efficacy of two myeloablative treatment regimens prior to hematopoietic stem cell transplantation. In the first group, 230 patients participated and in the second, 228.

Global differences in toxicity profiles and progression-free survival

They have not been detected among patients conditioned with BUMEL or MEL200 MEL200, except in three groups of patients with high risk factors in which BUMEL obtained a significant improvement in PFS compared to those treated with MEL200.

The application of the VRD-GEM, the intensified treatment in the induction and conditioning phases of the transplant, as well as the effect of the maintenance schemes associated with the trial, have been decisive in the results.

Important research on multiple myeloma is being done at university hospitals, medical centers, and other institutions around the world.

Every year, scientists find out more about what causes the disease and ways to improve treatments. Many new drugs are currently being tested.

Researchers have discovered that the supporting tissues of the bone marrow and bone cells produce growth factors that increase the growth of myeloma cells. In turn, the myeloma cells produce substances that cause the bone cells to undergo changes that weaken the bones.

These discoveries are helping researchers develop new drugs to block these growth factors, slow cancer and reduce bone destruction.

smoldering multiple myeloma

Although most patients with smoldering multiple myeloma are at low risk of developing active myeloma, there are certain patients with characteristics that cause them to be at higher risk of developing active myeloma.

Recent research shows that treating these patients sooner rather than waiting for symptoms may delay the onset of active myeloma and may also improve survival.

Minimal residual disease

Minimal residual disease is a term used when small numbers of myeloma cancer cells are still present in the bone marrow after treatment. Patients who do not have cancer cells after treatment seem to have a better survival rate than patients who still have even very small numbers of cancer cells.

New technologies are aimed at finding one myeloma cell in 1 million normal cells. Studies are underway to investigate whether getting rid of all myeloma cells (eradicating minimal residual disease) should be a goal of therapy.

therapy of T cells with chimeric antigen receptors (CAR)

The immune system helps keep track of all the substances that are normally found in your body.

Any new substance that the immune system does not recognize raises an alarm, causing the system to attack it. Chimeric antigen receptor T-cell therapy (CAR T-cell therapy) is a promising new way to get immune cells called T cells (a type of white blood cell) to fight cancer by altering them in the laboratory so they can find and destroy cancer cells.

Recent studies have shown that BCMA protein T-cell therapy holds great promise even in myeloma patients who have previously been treated with many drugs.



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