Rome, April 8 (beraking latest news Salute) – Every year, in Italy, 5,800 people are affected by multiple myeloma, a blood cancer that originates in the bone marrow. Innovative weapons such as immunomodulators, used in combination with other therapies, make it possible to significantly extend the time intervals free from relapse with a good quality of life, in many cases becoming chronic the disease. In fact, in twenty years the median survival has gone from about 36 months to 7 years. The perspectives offered by the innovative weapons against multiple myeloma are explored today in a virtual media tutorial, promoted by Celgene now part of Bristol Myers Squibb.
Immunomodulators – reads a note – have radically changed the prospects for treatment and, used in combination with drugs such as proteasome inhibitors and monoclonal antibodies, represent the real ‘backbone’ of treatment, from the first line up to the following ones. And the Car-T, which constitute the most advanced front of immunotherapy, are showing important results in heavily pretreated patients, with about 80% alive at one year compared to a life expectancy that did not exceed 9 months.
“Multiple myeloma is a typical disease of the elderly, the average age at diagnosis being approximately 70 years”, says Michele Cavo, director of the Institute of Hematology of Irccs S. Orsola-Malpighi, University of Bologna . “In about one third of cases the disease can begin without symptoms, while in the remaining two thirds the bone pain associated with the skeletal pathology are the most common symptoms. The therapy has been based for many decades on the administration of chemotherapy, with the possible addition of radiotherapy. The results obtained were modest, due to the high resistance of lymphocytes and plasma cells to treatments. The therapeutic innovation in the last 20 years has been represented by the introduction of drugs with direct action towards plasma cells and the medullary microenvironment ‘first of all immunomodulators “.
“In addition to immunomodulators – explains Cavo – proteasome inhibitors and monoclonal antibodies have also enriched the therapeutic scenario of multiple myeloma. These drugs have been usefully used first in patients with relapse-refractory disease and subsequently in those with newly diagnosed disease. variously combined with each other or with chemotherapy drugs. The therapeutic options available in the various phases of the disease have expanded considerably, and this has translated into a significant improvement in the life expectancy of patients “.
Lenalidomide, an immunomodulating drug, in combination with a proteasome inhibitor (bortezomib) and cortisone (dexamethasone), provides patients with newly diagnosed disease and not eligible for transplant a therapeutic option that significantly extends early remission. This ‘triplet’ was approved in Europe based on the results of the Swog s0777 study, which involved 525 patients. Median progression-free survival reached 42 months and median overall survival 89 months.
“The natural history of multiple myeloma has changed thanks to new drugs and, more recently, also through the increasingly massive use of immunotherapy, the doors of which have been opened by monoclonal antibodies. The most advanced and innovative frontier of immunotherapy it is now represented by Car-T cell therapy, based on the patient’s genetically modified lymphocytes “, concludes Cavo.