Can stall tactics work best for multiple myeloma?

February 16, 2012 | by City of Hope Staff

When an outright cure for a disease isn’t possible, medicine is going for the next best thing: keeping disease in a sort of suspended animation.

Photo of Amrita Krishnan Amrita Krishnan

It’s worked for HIV, a disease in which powerful drugs taken every day suppress the virus in many who have it, like basketball legend Magic Johnson. And it’s how many people with chronic myelogenous leukemia, like Johnson’s former teammate Kareem Abdul Jabbar, survive for years after their diagnosis (the drug Gleevec can stifle the leukemia and make it manageable.) Now researchers are trying to make similar strides against multiple myeloma, an aggressive cancer with no known cure.

City of Hope researchers and their colleagues around the world are working on combinations of treatments that could help many patients live longer with the disease, a blood cancer that develops in the bone marrow.

So far, no one treatment seems to get rid of the cancerous cells in multiple myeloma completely. Even when signs of cancer have vanished, the cells usually return. But using a series of new treatments could both improve patients’ response and reduce side effects — potentially helping many patients keep their cancer at bay for years.

In multiple myeloma, doctors are testing combinations of drugs that boost the immune system to fight cancer together with other new drugs called proteasome inhibitors, which prompt cancer cells to kill themselves. Together they can knock down and suppress multiple myeloma. More recently, physicians started to use them after stem cell transplantation to keep cancer in check.

A variety of approaches are now reaching patients through clinical trials, and researchers have found ways to make some medications powerful enough to suppress cancer while being gentler on the patient.

“We see reasons for optimism,” says Amrita Krishnan, M.D., director of City of Hope’s Multiple Myeloma Program. One recent City of Hope study showed that a new drug combination given after transplantation seemed to knock out cancer cells more deeply in many patients, “which we hope will ultimately translate into better survival.”

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