Current Research

Research for multiple myeloma is ongoing. The following advances may still be under investigation in clinical trials and may not be approved or available at this time. Always discuss all diagnostic and treatment options with your doctor.

Expanded use of stem cell transplantation. While autologous (AUTO) stem cell transplantation with high-dose chemotherapy is a standard treatment for myeloma, researchers are studying the benefits of tandem (double) AUTO transplantations, allogeneic transplantations, and tandem auto mini-allogeneic transplantations. Autologous means the stem cells are from the patient, and allogeneic means that the stem cells came from a donor. (For more information on transplantation, read the Treatment section)

New drugs. Rapid progress is being made in the treatment of myeloma. Several new drugs are being studied for the treatment of myeloma:

• Heat shock protein (HSP) inhibitors, also called stress proteins, are present in all cells to help them respond to environmental stresses, such as underheating or overheating. HSPs are overexpressed in the cells of certain cancer types and targeting them directly may help in the treatment of myeloma.
  
  
• Anti-angiogenesis inhibitors are drugs that block the action of a protein called vascular endothelial growth factor (VEGF) and are being tested in people with myeloma. VEGF promotes angiogenesis (the formation of new blood vessels), which is necessary for tumor growth and metastasis.
  
  
• The fibroblast growth factor receptor 3 (FGFR3) is expressed in approximately 15% of patients with myeloma and is involved in mitogenesis (cell growth), angiogenesis, and wound healing. Drugs that inhibit FGFR3 are being developed to help control cancer in these patients.
  
  
• p38 MAP kinase inhibitors block the production of cytokines (proteins produced by white blood cells that act as chemical messengers between cells), such as interleukin-6 and VEGF, in the bone marrow.
  
  
• Doxil (doxorubicin liposome injection) is a new way of delivering chemotherapy.

Myeloma represents a new treatment paradigm (a set of assumptions and practices) in cancer because the new drugs that target the tumor cell, tumor-bone marrow interaction, and bone marrow environment can overcome conventional drug resistance. Drugs are first tested in patients with advanced myeloma and then used to treat patients with earlier stage myeloma.

Drug combinations. Most myeloma cells will eventually become resistant to standard chemotherapy, a condition called multidrug resistance. New drugs and combinations of approved drugs are being researched to provide more options for patients with myeloma. One such combination is thalidomide, bortezomib, and dexamethasone. Another combination is bortezomib and lenalidomide. In May 2007, the FDA approved the combination treatment of bortezomib and doxil in people with myeloma whose disease has not responded to at least one other treatment.

Immunotherapy. This therapy, also called biologic therapy, helps to boost a person's immune system to fight cancer. It uses materials made either by the body or in a laboratory to bolster, target, or restore immune system function. Vaccines are a type of immunotherapy being explored in the treatment of multiple myeloma.