Multiple Myeloma Relapse — What are the Options?
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/ Updated February 28th, 2022

Multiple Myeloma Relapse — What are the Options?

Medical Source: Dr. Jens Hillengass
Roswell Park Comprehensive Cancer Center
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Multiple Myeloma Relapse — what are the Options? The good news is that with so many different drugs available to treat relapsed myeloma, there are plenty of combinations that may prove effective. Here's a brief overview of some of the drugs available to treat relapsed myeloma:

  • Proteasome inhibitors: they disrupt the mechanism by which cancer cells break down proteins. This build-up of protein within the cell eventually causes the cells to die. Examples include Velcade (bortezomib) and Kyprolis (carfilzomib):
  • Immunomodulatory drugs: they activate your immune system to target cancer cells and kill them like they would any other infection. Examples include Revlimid (lenalidomide), Immunoprin (thalidomide), and Pomalyst (Pomalidomide)
  • Dexamethasone: This is a steroid drug that prevents inflammation and associated pain from myeloma, and it can even help kill myeloma cells at high doses.
  • Immunotherapies: Typically, these are monoclonal antibody that 'tags' cancer cells for recognition by the immune system. One example is Dara (Daratumumab). (For more on Daratumamab go to this link.)

The goal in relapsed myeloma is to use treatments that have not previously been used on that patients myeloma. Ever heard of the saying, 'what doesn't kill you makes you stronger?' Well sadly, that's also true for myeloma cells. Myeloma cells that survive therapies are able to acquire resistance to them

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According to Dr. Jens Hillengass, Chief of Myeloma at Roswell Park Comprehensive Cancer Center, this is the key component to treating relapsed myeloma. "That's a very important part to use a treatment that you have not used before because if a cell survives a certain treatment we know they are kind of [sic] resistant to that." Approaches to varying treatments could mean using drugs not previously used, or using new combinations of previously used therapies.

There's also plenty of patient preferences that are key to planning treatment. Dr. Anderson underscores this, "Things like, would you rather take a pill, or would you rather have an infusion, or would you rather have like [sic] subcutaneous shot, those are factors we take into account when we counsel a patient about the treatment."

Learn more about SurvivorNet's rigorous medical review process.

Dr. Jens Hillengass is the Chief of Myeloma and a Professor of Oncology at Roswell Park Comprehensive Cancer Center. Read More

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Multiple Myeloma Relapse Options

When multiple myeloma comes back, the path for treatment is not always clear. We hope the perspectives here can help you make a better decision.

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