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Learning more about the changes inside multiple myeloma cells

Researchers are constantly learning more about the changes in the genes and proteins inside myeloma cells that help them grow. Knowing about these types of changes is helping them design better medicines to treat myeloma. It's also helping doctors figure out which myelomas are at higher risk for progressing. This could affect which treatments a person should get.

Researchers have also found that bone marrow support tissues and bone cells make growth factors that can help myeloma cells grow. In turn, the myeloma cells make substances that cause bone cells to undergo changes that weaken the bones. These discoveries are helping researchers develop new drugs to block these growth factors, slow down the cancer, and reduce bone destruction.

Learning more about smoldering multiple myeloma

Even though smoldering multiple myeloma (SMM) usually has a low risk of turning into active myeloma right away, in some people the SMM has features that put it at higher risk of developing into active myeloma.

Doctors are looking to better define which features of SMM make this more likely. Treating people whose SMM has these features, rather than waiting until symptoms appear, may help delay the progression to active myeloma, and it may also improve survival. This is an active area of research.

Treating multiple myeloma

There's been a great deal of progress in multiple myeloma treatment in recent years. While myeloma is still very hard to cure, many newer types of medicines have become available, which have greatly extended the length of time most people live with this disease.

Doctors are now trying to determine how best to combine these medicines, which order to use them in, and which ones might be more helpful for people whose myeloma has certain features (such as certain gene or chromosome changes).

For example, newer treatments such as bispecific T-cell engagers (BiTEs) and CAR T-cell therapy, which help the person's immune system find and attack the cancer cells, are now available. Most often, these are used later in the course of treatment, after other medicines have been tried. But doctors are now studying if using them earlier might be more helpful.

As researchers learn more about the gene and protein changes inside myeloma cells that help them grow, they are developing newer types of medicines to treat myeloma as well. Many of these are now being studied in clinical trials.