Can I Treat the Myeloma Now, Without Chemotherapy?

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Topics include: Treatments

Many patients continue to benefit from multiple myeloma treatments based on chemotherapy drugs. However, small molecules, immunomodulatory drugs and proteasome inhibitors all can cause side effects as they have the ability to penetrate every cell in the body, cancerous or not. Emerging immunotherapies, utilizing monoclonal antibodies, promise a chemo-free treatment future for some patients. But can the myeloma be treated now and avoid the toxicity of chemotherapy? In this video, Dr. Robert Orlowski discusses this question that is on the minds of so many of his patients.

This program was provided by the Patient Empowerment Network, which received funding from from Millennium: The Takeda Oncology Company and the Celgene Corporation.

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Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Andrew Schorr:

One last thing and that is chemo has helped many people, but people also know that it has side effects, risks that go with it. It can be tough, certainly most of the time. So there are some treatments that are non-chemo, and there are other drugs in development. One would wonder, can I have a non-chemo approach now as a bridge to when the new drugs are available?

Dr. Orlowski:

Well, that’s a great question, and we’re actually working on ideas in that area. Because of, for example, the monoclonal antibodies that were mentioned earlier, that are now becoming available, what we’re trying to do is put together a combination of treatments, which would involve two different antibodies. And we generally don’t think of those as being chemotherapies because they don’t get into every cell in the body, and so the side effects of them are much lower compared to small molecules like proteasome inhibitors or immunomodulatory drugs. They are small drugs which, once you take them, can go into every cell in your body, which is why they cause side effects.

If we could come up with a good combination of two different antibodies, for example, and add to it a drug like lenalidomide (Revlimid), which we know works by strengthening the immune system and, in part, not include dexamethasone (Decadron) in that, which is actually a chemotherapy many patients have many problems with, that’s the kind of direction that I think we need to be going in the future. And we’re working here at MD Anderson to get that kind of combination up and running in a trial as well. 

The hope is patients will have a great response to that and maybe never need chemotherapy. And if their disease does eventually progress, at least there won’t be resistance to the chemotherapy drugs that are available so that you will preserve the benefit of those drugs once you need to be treated with them. So I think that’s an exciting concept we’re working on.

Andrew Schorr:

Or you may have some new inhibitor of the growth of the cells, that isn’t chemo, that is a year, two, three years down the road.

Dr. Orlowski:

Well, I’m hoping that this combination of antibodies would be something that would be available, again, later this year or early next year on a clinical trial basis. We are working on new drugs that have new mechanisms of action. There are a couple of them that look exciting, but I think I would probably put them all in the category of chemotherapy drugs, in that they all work by killing myeloma cells and that, to some extent, they can get into normal cells, which means that there’s some risk of side effects.

Andrew Schorr:

I always am blown away Dr. Orlowski and his knowledge and bringing the wisdom to you. Dr. Robert Orlowski, chief of the myeloma section here at MD Anderson, thanks for answering all these questions. We’ll do it again soon.

Dr. Orlowski:

Great! Well, thanks again for putting this important program together.

Andrew Schorr:

Thank you. All right. So you’ll send us your questions. We’ll keep the dialog going to keep you informed, so you can get the care you need and deserve.

I’m Andrew Schorr on location at MD Anderson Cancer Center in Houston. Thank you for watching. Remember, knowledge can be the best medicine of all.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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Page last updated on January 7, 2015