Many Good Treatment Options for Multiple Myeloma Relapse
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/ Updated September 13th, 2021

Many Good Treatment Options for Multiple Myeloma Relapse

Medical Source: Dr. Kenneth Anderson
Dana-Farber Cancer Institute
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There are fortunately many good treatment options for people with relapsed multiple myeloma. To help you navigate through these options, it’s important to speak to someone who specializes in the management of relapsed myeloma. Dr. Ken Anderson, Director of the Multiple Myeloma Center at the Dana Farber Cancer Institute believes that "just because myeloma returns, doesn’t mean it can’t be effectively treated with many years of quality life." Some people who are treated for relapsed myeloma are living into their 80’s with a normal quality of life.

Myeloma cells that have survived after undergoing rounds and rounds of various treatments to cause relapse typically are the most resistant of the bunch. This is because relapsed myeloma cells have over twice as many mutations as when the disease previously appeared. In other words, they have twice as many ways of resisting previous treatments than they used to have.

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To treat this highly resistant form of the disease, in many cases, oncologists are now using 'second-generation' drugs. These are more recent adjustments and improvements to existing therapies.

For relapsed patients, the second-generation treatments include:

  • Kyprolis (carfilzomib) – is a proteasome inhibitor.
  • Pomalyst (pomalidomide) – 2nd generation immunomodulator.
  • Dexamethasone – a mainstay of myeloma treatment in both relapsed and initially diagnosed patients.
Daratumumab, an immunotherapy, is also added into the mix. More specifically, Dara is a monoclonal antibody that 'tags' cancer cells for quick and efficient recognition by the immune system.

In myeloma patients whose disease has come back repeatedly, oncologists may turn to therapies approved only for use in clinical trials, namely CAR T-cell therapy. "We’re using the CAR T-cells now literally in patients in whom have no other options," explains Dr. Anderson. CAR T-Cells are immune cells that are harvested from a patient's body, genetically modified to target specific cells (like multiple myeloma), and then reinfused back into a patient. Currently, it seems like patients are having about 12-18 months of positive response, which, according to Dr. Anderson, leaves lots of room for improvement.

"It’s very promising technology, but it’s a platform upon which many new attempts are being made to enhance the potency, make it more safe, but especially see if we can’t make it durable and have long-term disease-free survival and potentially a cure."

Learn more about SurvivorNet's rigorous medical review process.

Dr. Kenneth Anderson is the Director of the Jerome Lipper Multiple Myeloma Center and LeBow Institute for Myeloma Therapeutics at Dana-Farber Cancer Institute. Read More

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Multiple Myeloma Relapse Overview

Some of the leading specialists in the country provide their perspective on treatment approaches when multiple myeloma comes back.

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Multiple Myeloma -- Signs of Relapse
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Approach to Relapse in Multiple Myeloma
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When Multiple Myeloma Comes Back Quickly--Judgment Calls
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When Multiple Myeloma Returns, SurvivorNet's Resources

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