In this week’s column I would like to share some of my observations and thoughts about where I think the treatment of multiple myeloma is heading.

First, the good news: More drugs are being developed now for myeloma than for any other cancer. And, for the most part, they are working! These drugs—pomalidomide ^[1], carfilzomib ^[2], perifosine ^[3], Zolinza ^[4] (vorinostat), etc.—most often work best when combined with other approved novel therapy agents thalidomide ^[5] (Thalomid), Revlimid ^[6] (lenalidomide), and/or Velcade ^[7] (bortezomib).

Maintenance therapy after a stem cell transplant is proving to be helpful in delaying the return of the disease.

Fine tuning of therapies given to newly diagnosed patients prior to undergoing transplantation, called induction therapy, is helping extend the length of time that transplants work.

That is, if a patient decides to undergo a stem cell transplant at all! Novel therapy agents are working so well in some patients that they are able to postpone getting a transplant indefinitely.

Evidence is growing that bone strengthening agents, known as bisphosphonates, also help slow myeloma’s harmful effects. One of these drugs, Zometa ^[8] (zoledronic acid), may also contain some additional anti-myeloma properties.

Clinical studies are more numerous and accessible than ever. Many patients now have access to promising, new anti-myeloma therapies, even before they are approved by the Food and Drug Administration.

Next, here is some good and bad news: Life expectancies are rising impressively for some multiple myeloma patients, but not for others.

Younger, healthier patients with slower moving myeloma and fewer genetic abnormalities are really doing well. But others are not so lucky. Those with chromosomal abnormalities (conditions that help predict a type of myeloma which is more difficult to treat), some elderly patients, those with drug-resistant disease, or patients with other serious health problems continue to struggle.

The end result: Overall median life expectancies of all multiple myeloma patients, taken together as a group, are not rising as fast as one would hope.

Now the bad news: I just don’t see a “wonder cure” waiting around the next corner. Our economic system rewards research that produces fast, positive results. Although multiple myeloma is proving to be responsive to several different types of drugs, working to find a cure is expensive and takes a long, long time. So instead, researchers are focusing on the small battles they think they can win such as modest improvements on the current treatments, instead of the tougher, far more illusive war to find a cure.

The bottom line: Considering the fact that we all deal with having incurable cancer every day, the future looks very bright!

These days, when a person is diagnosed with multiple myeloma, they are often told something like this:

“I’m sorry to report you have a type of bone marrow cancer called multiple myeloma. There is no cure—but there is hope. We have five or six different ways to treat your disease. Until recently, the average multiple myeloma patients would die in four or five years. Now, many are living twice that long—some even longer.”

I know a few multiple myeloma patients who take little solace in knowing researchers are making progress—the specter of having an incurable cancer overwhelms them. I understand.

But I take great hope and comfort from the ongoing progress that multiple myeloma researchers are making. If scientists can continue to make progress at the current rate, most of us won’t need a cure! Like prostate cancer or diabetes, myeloma patients may soon be more likely to die from other causes than their cancer. Considering the circumstances, it doesn’t get much better than that!

Feel good and keep smiling! Pat