It is a common misconception that the myeloma protein is the primary agent that causes myeloma, but a combination of environmental factors and genetic predisposition play key roles in the development of multiple myeloma, as well as in multiple myeloma progression.
Multiple myleoma is a very incurable disease in the absence of effective therapy. It can be effectively treated by treatment aimed at improving the quality of life and the function of cancer-related symptoms.
The most frequent medications used to treat MM are bortezomib, thalidomide, lenalidomide, dexamethasone, and melphalan. The most common treatments used to treat relapsed cases of MM are thalidomide and dexamethasone alone. There is a lot more variation in the use of therapies to manage MM, which may result in sub-optimal effectiveness of treatment. More investigation of treatments used in the field is needed.
About 85,000 people in the United States develop multiple myeloma a year. Most of them are male, have a low body mass index, or have had multiple myeloma for 5 yr or more before diagnosis.
The most common type of blood cancer multiple myeloma is a cancer of the bone marrow and spine. Symptoms include bone pain, easy bruising and bleeding, low red blood cell levels, low white blood cell and platelet counts, and low neutrophil levels.\n
Signs of [multiple myeloma](https://www.withpower.com/clinical-trials/multiple-myeloma) may be present when there is a decrease of bone marrow mass (anemia) or when the white blood cell count is less than 15X107/L or when osteoclastic resorption is suspected. In addition to these signs of myeloma, there are signs that are specific for this disease: kidney failure, hepatomegaly, low albumin, an elevated blood calcium or high bone serum levels. A bone marrow biopsy is the only way to confirm the diagnosis of myeloma.
One trial, namely, the VEGITRAE trial, has not yet been done, but onc201 is being evaluated for two other cancers: (1) renal cancer by OCCASUS and (2) hepatocellular carcinoma by JUNQUS. We feel that it is unlikely onc201 will be as useful for the two former indications as it is for cancer immunotherapy.
Although the survival rate of MM is still poor, many patients still live long enough to [survive until the fifth year of survivorship after diagnosis.] Patients with myeloma are at an increased risk of developing various other cancers.
It is concluded that in the majority of cases, the primary (initial) MM has not been properly elucidated. Therefore, it is very valuable to determine the primary tumor to develop new effective treatment against this disease. A multidisciplinary approach to treat patients with multiple myeloma is recommended.
The number of reported clinical trials increased in recent years. This represents a growing need for a strong evidence base to support the use of new agents for the disease.
The addition of onc201 to other chemotherapy regimens results in a higher response rate, overall survival and progression-free survival and could potentially prove to be a feasible strategy. However, further studies, with a randomization design, are needed to confirm the reported results in a larger number of patients.
There is a high likelihood (89%) of developing a pre-malignant condition within the first 5years after diagnosis of MM, and more than 10 years after diagnosis, there is a significant risk of developing MM. A combination of age, time from diagnosis of MM, and treatment type are most strongly linked to the development of MM in older patients. Given the growing numbers of patients treated for MM and their increased age, it is important to monitor the progression of pre-malignant conditions such as ALT, and the development of MM in elderly patients.