When myeloma comes back, a different arsenal of weapons is needed to fight back against the cancer. There are a number of reasons why a relapse is so difficult. The myeloma cells that remain to cause relapse are typically the most resistant. Plus, the mutations are more numerous.
As Dr. Paul Richardson, Director of Clinical Research at Dana-Farber Cancer Institute's Multiple Myeloma Center, explains, “We've shown this in our clinical trials that when, for example, a patient presents with newly diagnosed myeloma and we interrogate the genetics of their cancer, we see over 5,000 mutations.” But in the same patient who undergoes therapy but relapses “that patient is found to have 12,000 mutations in their disease.” A larger number of mutations in cancer cells means drugs will likely be less effective because there is greater resistance to therapies.
Read MoreExpert Resources On Multiple Myeloma Relapse
- Proteasome inhibitors–these disrupt the mechanism by which cancer cells break down proteins internally. This build-up of protein within the cell eventually causes the cells to die.
- Immunomodulatory drugs–these activate your immune system to target cancer cells and kill them like they would any other infection.
- Monoclonal antibodies–these are single, specific proteins that initiate a variety of cancer-fighting process within the body, including recruitment of immune cells to the cancerous area. One typical example is Dara (daratumumab).
- Next generation small molecules–these are generalized drugs that kill cancer cells by inducing cell death (like the drug Venetoclax) or by inhibiting gene expression (HDACs).
By combining these various drugs, relapsed myeloma can be tackled in multiple different ways and lead to better outcomes.
Learn more about SurvivorNet's rigorous medical review process.
