Multiple Myeloma:  Some Good News!

By Shlomo Maital

    Multiple myeloma is an incurable blood cancer that affects cells inside a patient’s bone marrow. Nearly all multiple myeloma patients will relapse at some point in their treatment, becoming resistant to first one, then another frontline intervention.  

    Globally, multiple myeloma affected 488,000 people and resulted in 101,100 deaths in 2015. In the United States, it develops in 6.5 per 100,000 people per year and 0.7% of people are affected at some point in their lives. It usually occurs around the age of 60 and is more common in men than women. 

   According to the latest edition of Science Friday, “a new kind of [multiple myeloma] therapy, a bispecific antibody called Talquetamab, has been showing promise in clinical trials—both in treating the cancer, and keeping patients in remission longer. A bispecific antibody works as a kind of bond between a T-cell that might otherwise not be doing its job and the myeloma cell itself, forcing the T-cell to attack the cancer.”   An amazing 70% of patients who got the treatment went into remission, including ones seriously ill. 

  How does it work?  The powerful antibody has a “Y” shape.  One branch of the “Y” latches on to cancer cells (it’s designed to do this – that’s why this technology is called ‘designer antibodies’).  The other branch of the “Y” latches on to the body’s immune system T cells, that kill cancer.  When the T cells and cancer cells are in proximity, the T cells emit chemicals that penetrate the cancer cell and kill it.  Basically, this treatment is like a smart deputy sheriff, who rounds up the bad guys, and puts them in a cell so the sheriff can book them and prosecute them. 

    This approach is promising, because it is far less expensive than the designer CAR-T cell approach and is available at leading academic medical centers. CAR-T has to be tailored to each individual. Talquetamab works on everyone.

      Dr. Ajai Chari led the clinical trials of Talquetamab.   He is in charge of hematology oncology at Mt. Sinai Hospital in New York City.  For follow-up, go to the Mt. Sinai Hospital website.