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Heartbeat: Revolutionary myeloma research offers new hope for patients

April 11, 2023

Myeloma is a type of blood cancer that is caused by abnormal plasma cells in the bone marrow. This can cause a range of unpleasant symptoms, including bone pain, an increased risk of infections, fatigue and kidney failure. It mainly affects people over the age of 65, but can also be diagnosed in much younger individuals. In the UK, around 2 per cent of all cancers diagnosed are myeloma and it accounts for 15 per cent of blood cancers.

Fortunately, research in myeloma at SWBH has greatly improved the survival and quality of life of myeloma patients. Over the last 50 years, the one-year survival rate has increased from 37 per cent to around 85 per cent in 2020. This is due to an increased understanding of the disease and the development of new treatment options through research.

In the early 2000s, treatment options were severely limited, but a trial of thalidomide led to the first new drug approved for myeloma treatment in over three decades. Since then, there have been many trials that have led to more treatment options for patients. Dr. Farooq Wandroo, Lead Haematology Research Consultant, has been involved in some of these trials, which have led to changes in best practice throughout the world.

One such trial, Myeloma XI, was the world’s largest national trial open at our Trust for newly diagnosed myeloma patients. It compared the use of cyclophosphamide and dexamethasone in combination with either thalidomide or lenalidomide. This trial showed that the use of lenalidomide as maintenance therapy led to a significant benefit to all patients for progression-free survival as well as overall survival. As a result, NICE recommends the use of lenalidomide as maintenance treatment for newly diagnosed myeloma patients after autologous stem cell transplant.

SWB also participated in the Tackling Early Morbidity and Mortality in Myeloma (TEAMM) trial, which showed that giving antibiotic prophylaxis during the first three months of treatment prevents pneumonias in myeloma patients. This research has been published and has led to changes in practice around the world.

Unfortunately, patients with high-risk subsets of myeloma have benefited less from these therapeutic advances. The new Risk-Adapted therapy Directed According to Response (RADAR) trial aims to identify myeloma patients with high-risk disease at presentation through cytogenetic testing. By identifying these patients early, it would allow for new targeted novel anti-cd38 antibodies to improve their outcome, which would not be possible without the trial.

SWB has also created a myeloma patient support group (MMSG) to keep patients aware of new developments. In addition, we are participating in a number of collaborative research projects via West Midlands Research Consortium (WMRC) and basic translational research with the University of Birmingham. With MMUH coming, these collaborations will provide exciting life-changing treatments for patients. Overall, research in myeloma at SWB has made significant progress in improving the survival and quality of life of myeloma patients, and the future looks promising for continued advances in treatment options.