Multiple Myeloma Treatment

Multiple myeloma occurs when plasma cells in the bone marrow grow out of control. When they become cancerous, tumors can form in the bones. One tumor of cancerous plasma cells is called a plasmacytoma. Cancerous plasma cells produce a large amount of an abnormal protein (antibody).¹

Treatment for multiple myeloma is based on several factors, including:²

• Stage of the disease
• Whether certain antibodies are present
• Whether certain genetic mutations are present
• Whether the kidneys are damaged
• How the cancer responds to initial treatment
• The age and general health of the person with cancer

Types of treatment for multiple myeloma

Several different types of treatment may be used for multiple myeloma, including:²

• Chemotherapy
• Targeted therapy
• Immunotherapy
• Radiation therapy
• Watchful waiting
• Surgery
• Stem cell transplant

Treatment for multiple myeloma may include combination of different types. Clinical trials are studying new combinations of treatments.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy works by targeting fast-growing cells, such as cancer cells. However, other fast-growing cells in the body can also be affected, such as those in the gut and hair.²

Chemotherapy drugs may be used together with other drugs or alone. They may be taken by mouth or injected into a vein or muscle, depending on the specific medicine.²

Targeted therapy

Targeted therapies are cancer treatments that block or slow specific cancer cells. They do this by interfering with specific areas of cancer cells involved in growth. They may also target specific features that are unique to cancer cells.²

While chemotherapy drugs typically kill cancer cells, targeted therapy usually blocks the growth of cancer cells. Types of targeted therapy used to treat multiple myeloma include:^2,3

• Monoclonal antibodies – antibodies designed to target proteins on cancer cells or deliver chemotherapy drugs to cancer cells
• Proteasome inhibitors  – drugs that prevent cancer cells from breaking down proteins
• Nuclear export inhibitors – drugs that block the transport of proteins from the nucleus to other parts of the cell

Immunotherapy

Immunotherapy aims to boost your own immune system to fight cancer cells. There are several types of immunotherapies used to treat multiple myeloma, including:^2-9

• Immunomodulators (IMiDs) – drugs that lead to the breakdown of proteins important for cancer cell growth
• Chimeric antigen receptor (CAR) T-cell therapy – removes T cells from your body, altering them to attach to cancer cells, and putting them back in your blood
• Bispecific T-cell engagers (BiTEs) – uses antibodies to help T cells interact with cancer cells

Radiation therapy

Radiation therapy uses high-energy radiation. Radiation may be used to treat plasmacytoma or tumors in multiple myeloma that have not responded to chemotherapy.^2,10

Watchful waiting

Your doctor may recommend watchful waiting if you are not experiencing symptoms. During watchful waiting, you do not receive treatment for multiple myeloma. However, problems like infections are treated. Your doctor will closely monitor your health and watch for any appearance of symptoms.²

Stem cell transplants

Stem cell transplants are used with high doses of chemotherapy. The high doses of chemotherapy destroy cancer cells. However, they also damage healthy blood cells. The transplant of stem cells (immature blood cells) restores your body’s blood cells.²

The stem cells may come from the person before chemotherapy. This is called an autologous transplant. When they may come from a donor, it is called an allogeneic transplant. High doses of chemotherapy can be taxing on a person’s body. Not everyone is a candidate for stem cell transplants. High doses may not be tolerated by older adults or people with other health problems.²

Clinical trials

Clinical trials are a type of research where new treatments are studied. Clinical trials are an important part of the scientific process to find and prove the safety and effectiveness of new treatments.^2,11

They offer people a chance to receive the latest treatments and be closely monitored by doctors. You can learn more about clinical trials by talking to your doctor or visiting the ClinicalTrials.gov website. Your doctor can help you decide if a clinical trial may be right for you.^2,11