Multiple Myeloma is a Treatable Cancer
Multiple myeloma treatment options have increased significantly over the last 10 years. New myeloma treatments have resulted in improved survival among multiple myeloma patients. Even more encouraging, there are many promising new therapies under investigation now. We are not just accelerating the development of the next treatment, but by seeking to customize treatments based on our mapping of a patient’s genome, we are accelerating the development of the right treatment for each patient who urgently needs it.
The importance of genomics
One area researchers are working on is better understanding the biology of multiple myeloma. Through genomic studies (studies of the tumor cell DNA), we have learned that there are many DNA alterations in myeloma cells, and these frequently differ from patient to patient. The ultimate goal of genomic research is to develop personalized treatments based on the DNA in the myeloma cells of individual patients. These frequently differ from patient to patient. There is not one set of defining alterations.
Today, we know that certain DNA alterations indicate how aggressive the myeloma is and, in some cases, test results can help guide treatment decisions or determine eligibility for clinical trials.
DNA alterations and treatment
For most DNA alterations, there are not enough data to guide treatment decisions. An exception is t(4;14). This is one of a type of chromosomal abnormalities called translocation in which a chromosome breaks and a portion of it reattaches to a different chromosome.
Studies have shown that patients with t(4;14) have better outcomes when treated with a proteasome inhibitor, such as Velcade. In fact, when patients with t(4;14) are treated with Velcade, their outcomes may be better than patients with this DNA alteration who don’t receive this drug.
Factors determining treatment
There is no one standard treatment. A patient’s individual treatment plan is based on a number of things, including:
Age and general health
Results of laboratory and cytogenetic (genomic) tests
Symptoms and disease complications
Prior myeloma treatment
Patient’s lifestyle, goals, views on quality of life, and personal preferences
In addition, many cancer centers have developed their own guidelines for treating myeloma, and these may vary between centers.