Relapsed multiple myeloma is myeloma that has remained despite treatment or has returned after initial treatment. It is uncommon for people with recurrent myeloma to get cured with a current lot of treatment and therapy. However, the survival has increased by several years with immunotherapy, new precision medicines, maintenance therapy and stem cell transplantation.
Doctors are researching on the genetic alterations of cancer that boosts its growth and administer medicines that could counteract the carcinogenic effects of these genes. These targeted therapies luckily work on only cancer cells, and the healthy, normal cells have to suffer no or minimal damage.
There has been an influx of newer precision medicines, and they are being used along with immunotherapies to treat people with recurrent multiple myeloma. The results are phenomenal. The sole curative treatment for this condition is still the high-dose therapy coupled with stem cell transplant using donor cells which are also called allogeneic stem cell transplant.
Treating recurrent multiple myeloma patients
Recurrent cases of multiple myeloma cancer have been already administered chemotherapy or undergone stem cell transplant. The best treatment for relapsed multiple myeloma is to completely eliminate the myeloma cells for prolonged survival and improved symptoms. Treatment is strategized based on the general medical health, age and prior therapy of the patient.
List of medicines
The following is a list of medicines that have been approved by the Food and Drug Administration to use in the treatment for multiple myeloma. These medicines are better used in combinations to yield an optimal result.
- Darzalex (daratumumab)
- Empliciti (elotuzumab)
- Farydak (panobinostat)
IMiDs (immunomodulatory drugs)
- Thalomid (thalidomide)
- Pomalyst (pomalidomide)
- Revlimid (lenalidomide)
- Velcade (bortezomib)
- Ninlaro (ixazomib)
- Kyprolis (carfilzomib)
Alkylating agents (chemotherapy)
- Alkeran (melphalan)
- Cytoxan (cyclophosphamide)
- Oncovin (vincristine)
- Steroids (e.g., prednisone and dexamethasone)
Combinations would mainly comprise of medicines that have not been used as initial treatment. IMiD is often paired with a proteasome inhibitor and precision medicine with dexamethasone. To determine optimal combination regimes clinical trials should be conducted.