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Health & Medicine for Senior Citizens

Sorafenib May Be New Treatment for Multiple Myeloma Blood Cancer That Strikes Seniors

Sorafenib is drug used now for advanced cancer of the kidneys and liver

Sept. 5, 2012 – Multiple Myeloma is a common form of blood cancer that is usually diagnosed after people pass age 60. Although considered incurable, it often progresses slowly and is usually controllable. A problem in treatment, however, is the development of resistance to treatment drugs, according to an oncology researcher, who thinks he has found a new drug that works – sorafenib.

Research from Karolinska Institute shows that sorafenib, a drug used for advanced cancer of the kidneys and liver, could also be effective against multiple myeloma.

"Recently developed drugs, like bortezomib, have increased the survival rate for people with this serious and complex disease," says study leader Theocharis Panaretakis, docent of experimental oncology.

"Having said this, the heterogeneity of the disease progression, the treatment response and the development of resistance to administered drugs which leads to the relapse of nearly all patients, has compelled us to find new and better treatments."

Myeloma is only found in older adults; it is uncommon before the age of 40, and most patients are over 60 years when diagnosed. The disease can lie dormant in the body for many years, but only becomes life-threatening and requires treatment once the patient has begun to exhibit symptoms. (See more by National Cancer Institute below this news report.)

The myeloma cells are mainly located in the bone marrow, and since this is where blood cells are produced, their presence seriously disrupts regular blood production. Malignant cancer cells or tumors can also accumulate outside the bone marrow, hence the term “multiple.”

 

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A common effect of multiple myeloma is osteoporosis, and as a consequence patients develop intense back pain as their vertebrae become compressed as well as bone fractures. Other symptoms are anemia, fatigue, renal failure and, often, a greater susceptibility to infection.

The current study, which is published in the scientific journal Cancer Research, was conducted on cell samples from humans and mice (cell lines). Almost all myeloma patients, seen at Karolinska University Hospital, were previously untreated.

The researchers show how sorafenib induces cell death in human myeloma cell lines in a laboratory environment by preventing a certain kind of protein-level activity, an effect that also was achieved when the myeloma cells had developed a resistance to bortezomib.

They also tested sorafenib in live mice and found that the drug either prevented or delayed the course of the disease. All in all, the researchers maintain that their results support the use of sorafenib in combination with other drugs in the treatment of multiple myeloma.

Research groups from Uppsala University and Belgium were also involved in the study. The project was financed by the Swedish Cancer Society, the Swedish Research Council, the Cancer Society in Stockholm and the Ake Wiberg Foundation.

>> More about sorafenib


About Multiple Myeloma by National Cancer Institute

Multiple myeloma is a cancer that begins in plasma cells, a type of white blood cell. These cells are part of your immune system, which helps protect the body from germs and other harmful substances. In time, myeloma cells collect in the bone marrow and in the solid parts of bone.

No one knows the exact causes of multiple myeloma, but it is more common in older people and African-Americans. Early symptoms may include

   ● Bone pain, often in the back or ribs

   ● Broken bones

   ● Weakness or fatigue

   ● Weight loss

   ● Repeated infections

Myeloma is hard to cure. Treatment may help control symptoms and complications. Options include chemotherapy, stem cell transplantation and radiation.

People with multiple myeloma have many treatment options. The options are watchful waiting, induction therapy, and stem cell transplant. Sometimes a combination of methods is used.

Radiation therapy is used sometimes to treat painful bone disease. It may be used alone or along with other therapies. See the Supportive Care section to learn about ways to relieve pain.

The choice of treatment depends mainly on how advanced the disease is and whether you have symptoms. If you have multiple myeloma without symptoms (smoldering myeloma), you may not need cancer treatment right away. The doctor monitors your health closely (watchful waiting) so that treatment can start when you begin to have symptoms.

If you have symptoms, you will likely get induction therapy. Sometimes a stem cell transplant is part of the treatment plan.

When treatment for myeloma is needed, it can often control the disease and its symptoms. People may receive therapy to help keep the cancer in remission, but myeloma can seldom be cured. Because standard treatment may not control myeloma, you may want to talk to your doctor about taking part in a clinical trial. Clinical trials are research studies of new treatment methods. See the Taking Part in Cancer Research section.

Your doctor can describe your treatment choices, the expected results, and the possible side effects. You and your doctor can work together to develop a treatment plan that meets your needs.

Your doctor may refer you to a specialist, or you may ask for a referral. Specialists who treat multiple myeloma include hematologists and medical oncologists. Your health care team may also include an oncology nurse and a registered dietitian.

Before treatment starts, ask your health care team to explain possible side effects and how treatment may change your normal activities. Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects may not be the same for each person, and they may change from one treatment session to the next.

Many different types of drugs are used to treat myeloma. People often receive a combination of drugs, and many different combinations are used to treat myeloma.

Each type of drug kills cancer cells in a different way:

   >> Chemotherapy: Chemotherapy kills fast-growing myeloma cells, but the drug can also harm normal cells that divide rapidly

   >> Targeted therapy: Targeted therapies use drugs that block the growth of myeloma cells. The targeted therapy blocks the action of an abnormal protein that stimulates the growth of myeloma cells.

   >> Steroids: Some steroids have antitumor effects. It is thought that steroids can trigger the death of myeloma cells. A steroid may be used alone or with other drugs to treat myeloma.

You may receive the drugs by mouth or through a vein (IV). The treatment usually takes place in an outpatient part of the hospital, at your doctor's office, or at home. Some people may need to stay in the hospital for treatment.

The side effects depend mainly on which drugs are given and how much:

More at NIH: National Cancer Institute

 

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