Kamal Fadalla
Consultant Haematologist, UCD
Associate Clinical Professor, St Vincent’s University Hospital and Univerisity College Dublin
Treatments for the blood cancer myeloma are emerging, with many at the final stages of clinical trials. Myeloma treatment aims to either bring patients into remission or manage its effects to improve their quality of life.
Multiple myeloma is caused by abnormal cells called plasma cells. Currently, myeloma patients are continuously monitored and undergo treatment throughout their lives. However, many new treatments are emerging. The two main ones are chimeric antigen receptor T-cell (CAR-T cell) therapy and bispecific antibodies.
Modern myeloma treatment
CAR-T-cell therapy is a new modality of treatment that harnesses genetic engineering. We collect immune cells from the patients (T-cells), and through genetic engineering, we insert receptors into those cells and re-infuse them back to patients. These genetically modified cells circulate in the blood to identify abnormal plasma cells and then stimulate the immune system to kill these plasma cells.
A new group of medicines, called bispecific antibodies, is also emerging. It is a ready-made medicine infused to the patient. Similarly to CAR-T-cells, it identifies plasma cells and stimulates the host’s immune system to get rid of them.
CAR-T-cell therapy is a new modality of
treatment that harnesses genetic engineering.
Unmet needs for myeloma
Despite advances in myeloma treatment, there are still unmet needs, including:
- Lack of a cure. However, with improved treatment, or combined treatments, it might be achieved in the near future.
- Reducing the toxicity of treatment (especially stem cell transplant), which many patients cannot tolerate.
- Improving survival rates for young patients, as prolonging life by 8–12 years is not sufficient for many patients.
- Reducing treatment time, as almost all myeloma patients require continuous treatment, which negatively impacts their quality of life.
- Treatment for elderly, frail patients who may not tolerate the same treatment as younger patients.
If these unmet needs are addressed as promising treatments advance, patients with myeloma could live longer, healthier lives.