Multiple myeloma is a rare type of bone marrow cancer, which can include a range of symptoms including painful and weak bones which break easily, tiredness and shortness of breath, repeated infections and sometimes bruising and bleeding. Currently there is no cure for Myeloma, but treatments can control it for some time.
A group of patients recently gathered to talk about their experiences of Myeloma, outlining their priorities for research. They produced a list of ten priority questions which will serve to guide clinicians and scientists. Some of the questions mirrored current research priorities, reinforcing the value of addressing these areas.
One important question related to the short and long-term side effects of myeloma treatment. Dr Karthik Ramasamy from Radcliffe Department of Medicine, University of Oxford, is working on the Myeloma XV trial, which is gathering data about how patients respond to treatment and how genetics might influence the level of risk for disease progression. This research will help clinicians to more effectively match patients to treatment. Identifying patients who would not need to have such intensive treatments is expected to reduce the likelihood of side effects.
The patient panel also asked about how myeloma patients can receive the best drug for the genetic subtype of their disease. This area of research is known as precision oncology, where genetic studies can identify which type of disease is present, and which treatments could be used. Dr Sarah Gooding is beginning a five-year fellowship sponsored by Cancer Research UK at the MRC Weatherall Institute of Molecular Medicine, where genetic monitoring will be used to identify when patients are becoming resistant to commonly used IMID drugs. Oxford patients have already made a brilliant contribution to this research, by donating samples to the Oxford HaemBio Biobank. These samples have been analysed by whole genome sequencing to show how resistance emerges.
The best outcomes are when myeloma is diagnosed early. The earliest stage of myeloma is a benign condition called monoclonal gammopathy of undetermined significance (MGUS), and from this condition only 20% of patients progress to myeloma. A new monitoring service has begun in Oxford, which aims to identify those patients with MGUS and carefully track symptoms to pick up myeloma early.
Finding a cure for multiple myeloma is a long-term aim. The plasma cells which give rise to cancerous myeloma cells have a very long lifetime in the body, and so it can be difficult to eliminate every single myeloma cell. Researchers continue to explore potential cures including immunotherapies which may be effective in some cases.
Partnerships in medical research are critical to new advances in treatment, explains Dr Sarah Gooding, “By bringing together patients, doctors and scientists, we hope that new advances in myeloma detection and treatment will soon be available to improve disease outcomes and improve the quality of life for those with myeloma.”