When Giovanni Allevi went on stage in Sanremo to talk about his illness, many wondered what it was about. In fact, multiple myeloma is not often talked about, despite the fact that it affects around 5 thousand Italians every year, so much so that it is the second most common blood cancer. To fill this information gap and raise awareness among the population towards research and assistance, the Italian Association against Leukemia, Lymphoma and Myeloma (AIL) dedicates the month of March to this pathology, strengthening the dedicated services and information channels.
The illness
Pain, fatigue, bone fragility. These are the signs that should set off alarm bells, especially in people over 65. Multiple myeloma in fact arises on average around the age of 70 and has a heavy impact on both a physical and psychological level. It is a disease caused by the neoplastic transformation of a cell of the B lymphocyte line, called plasma cell, and is characterized by the alternation between periods of remission and the appearance of relapses. Fortunately, thanks to the availability of numerous therapeutic options, patients today are able to obtain increasingly better and deeper responses which increase the duration of remission periods and even life expectancy. In particular, in recent years, new treatment perspectives have opened up thanks to immunotherapy, i.e. therapy that acts on the patient’s immune system.
Modified lymphocytes
CAR-T (chimeric antigen receptor T cell) therapies exploit the action of the T cells of the immune system which are modified so as to specifically target tumor cells. To do this, it is necessary to take the patient’s T lymphocytes, treat them in the laboratory by inserting a portion of DNA “educated” to recognize multiple myeloma and subsequently reinfusing the thus prepared T lymphocytes into the patient’s bloodstream. It is therefore a true “personalized treatment”. There are two CAR-T cell therapies approved at European level for multiple myeloma, but only one of these is currently available in Italy.
“We can say that this is the beginning of a new era in the treatment of multiple myeloma because CAR-Ts represent an option for patients with advanced and refractory disease for whom there was no standard of care to date,” he underlined. Michele Cavo, Director of the “Seràgnoli” Hematology Institute – University of Bologna. “They are reserved for what are technically called triple exposed patients and with disease refractory to the last line of therapy prior to the use of CAR-T cells”.
Double attack
Another strategy that exploits the immune system is the one that uses bispecific antibodies, molecules capable of guiding the cells of the immune system towards those of the tumor and fighting the diseased cells. A technology which, after decades of research and clinical trials, is now capable of giving significant results in the majority of patients.
“The use of bispecific antibodies in patients undergoing relapse represents an important therapeutic opportunity. Studies have shown that they are able to induce remission in 2 out of 3 patients with a duration exceeding 12 months, much longer than what happens with other drugs usually used for advanced stage patients”, explains Roberto Mina, researcher at the University of Turin. “There are three bispecific antibodies currently approved, but there are at least 5 others being tested, demonstrating the therapeutic potential of this class of molecules”.
AIL’s commitment to patients
The Association, in addition to promoting information and awareness campaigns, is also committed to offering free services to patients who face this disease every day, so as to never leave them alone on their journey. We are talking about home care services, transport to and from hospital facilities, psychological support and hospitality in AIL homes, facilities which are located near the main blood centers and which host patients and family members forced to move from their city of residence for treatment. For more information on the services offered by the Association and how to access, simply visit the AIL.it website.