 | Author(s) | | | Smith M |
| Publication | | | Oncology Times UK & Eire |
| Publication Date | | | March 2004 |
|  | This paper highlights the new therapies available and under trial for patients with multiple myeloma. Offering new hope for extended remission periods and maybe cure.
Thalidomide is currently being trialled for a number of conditions exploring the anti-angiogenic effects, of these conditions myeloma cells show a response to Thalidomide.
An interruption in the adhesion of myeloma cells to the bone marrow stroma, and reduced growth factors which act as disease promoters.
There are side effects to consider such as somnolence, constipation, neuropathy and rash which can be dose limiting.
Current treatment combines low dose thalidomide with dexamethasone to reduce the side effects and results show an improvement from combination chemotherapy.
Another trial is to replace thalidomide with immunomodulatory drugs (ImiDs), this is purported to be as effective and reduce side effects.
The proteasome inhibitor bortezomib is also being studied; it enhances response to alkylating agents, blocks adhesion to the stroma and appears to have an apoptotic effect on myeloma cells
Stem cell transplants both autologous and allogenic continue to be used to increase survival and remission rates, but the transplant related mortality issues need to be considered.
Interleukin 2 (IL-2) is being trialled as IL-2 increases T cell activity, has an antitumour effect and stimulates lymphokine activated and natural killer cells, at present this is a phase II study.
It is interesting to note the trials which are currently ongoing; nurses need to be aware of these to identify necessary preparations and patient information needed.
Comment by: Tracey Burgoyne, BSc Clinical Nursing Studies, Lecturer/Practitioner at University aof Central England, 2004.
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