Personalizing Blood Cancer Treatment

Multiple myeloma treatment guidelines put forth by Mayo Clinic

(RxWiki News) Huge advances have been made in the understanding of multiple myeloma. There are a variety of approaches for treating this blood cancer. The trick is to provide what’s best for the individual patient.

Researchers at the Mayo Clinic have developed treatment guidelines for patients who have been newly diagnosed with multiple myeloma.

The recommendations are designed to help doctors choose among therapy options.

These guidelines may help patients with low-risk disease avoid the toxic side effects of aggressive therapies, according to the researchers.

"Research your cancer online."

Multiple myeloma is an incurable blood cancer that’s diagnosed in about 22,000 Americans each year.

Joseph Mikhael, MD, a hematologist at Mayo Clinic in Arizona, worked with other Mayo blood cancer specialists in Minnesota and Florida to develop the guidelines.

"Over the past decade we have made great progress in understanding the disease, developing drug therapies and increasing overall survival. However, as a medical community we haven't done as good a job at optimizing therapy based on a patient's individual risk factors," Dr. Mikhael said in a statement.

The goal of the guidelines is to outline a treatment path for physicians to follow. Everything from initial therapy to stem cell transplant and maintenance therapy is covered.

Newly diagnosed multiple myeloma patients should be encouraged to enroll in clinical trials for both therapy and supportive care, the researchers wrote.

There are currently about 10 different medications available to treat multiple myeloma, with dozens of potential combinations.

Classifying the patient’s disease is one of the first things that can be helpful in pinpointing appropriate treatment.

The authors suggested that all patients should be grouped into low-risk, intermediate-risk and high-risk disease categories.

Gene profiling tests can be used to identify disease that’s likely to be at high risk and needs more aggressive treatment.

The Mayo researchers also suggested that stem cell transplants should be delayed so improved chemotherapies can be relied upon more heavily.

Also covered were the risks and benefits of various maintenance medications, including lenalidomide (Revlimid) and bortezomib (Velcade).

“The treatment of multiple myeloma remains complex, with multiple conventional and novel therapies available to the clinician. However, this consensus statement provides a risk-stratified, evidence-based, and clinically practical approach to the treatment of patients with this as yet incurable disease,” the authors concluded.

This study was published in the April issue of Mayo Clinic Proceedings. Several authors disclosed having financial ties to various companies, including Celgene (maker of Revlimid), Millenium (maker of Velcade), Janssen, Medtronic, Onyx, Otsuka, Genzyme, BMS, Lilly, Binding Site, Amgen, Abbott and Cephalon.

Review Date: 
April 3, 2013