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What is Chemotherapy for Myeloma?
What is chemotherapy for myeloma patients and survivors? As more and more classes of chemotherapy regimens have been invented, the meaning of the term chemotherapy has become more confusing.
According to the National Cancer Institute (NCI) the term chemotherapy is “Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing…”
I found this video to be a good, basic explanation of chemotherapy
The confusion starts when oncology wants to specify a class of chemotherapy regimen. Some different types or classes of chemotherapy regimens are listed below-
1. Alkylating Agents
These drugs damage the DNA of cancer cells, preventing them from replicating. They are among the oldest classes of chemotherapy used in multiple myeloma.
- Examples:
- Melphalan: Often used in high doses prior to stem cell transplantation.
- Cyclophosphamide: Commonly combined with other agents in combination regimens.
2. Corticosteroids
Though not traditional chemotherapy, corticosteroids play a central role in multiple myeloma treatment. They have direct anti-myeloma effects and enhance the activity of other drugs.
- Examples:
- Dexamethasone
- Prednisone
3. Proteasome Inhibitors
These target the proteasomes in cancer cells, leading to protein accumulation and cell death.
- Examples:
- Bortezomib (Velcade): Administered as an injection.
- Carfilzomib (Kyprolis)
- Ixazomib (Ninlaro): An oral proteasome inhibitor.
4. Immunomodulatory Drugs (IMiDs)
These drugs modulate the immune system and target cancer cells directly.
- Examples:
- Lenalidomide (Revlimid)
- Thalidomide
- Pomalidomide (Pomalyst)
5. Anthracyclines
These drugs interfere with enzymes involved in DNA replication, causing cell death.
- Examples:
- Doxorubicin (often given in liposomal form for better targeting).
6. Combination Chemotherapy Regimens
In practice, multiple myeloma is often treated with combination regimens that include drugs from different classes to maximize efficacy. Common regimens include:
- VRd: Bortezomib, Lenalidomide, and Dexamethasone.
- CyBorD: Cyclophosphamide, Bortezomib, and Dexamethasone.
- D-PACE: Dexamethasone, Cisplatin, Adriamycin (Doxorubicin), Cyclophosphamide, and Etoposide.
Emerging Chemotherapy Approaches
In addition to traditional chemotherapy, targeted therapies like monoclonal antibodies (e.g., Daratumumab) and bispecific antibodies are being used. These aren’t strictly “chemotherapy” but often part of the comprehensive treatment plan.
I was first diagnosed with MM in early 1994. The diagnosis and treatment of MM was very different then. Yes, MM is still incurable. But newly diagnosed MM patients have a lot more to work with now.
The two issues to remember are:
- all chemotherapy regimens for MM are cytotoxic to MM
- all chemotherapy regimens cause short, long-term and late stage side effects
Email me at David.PeopleBeatingCancer@gmail.com with questions about chemotherapy for myeloma.
Good luck,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
“(KEE-moh-THAYR-uh-pee)
Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, or infusion, or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy, or biologic therapy.”
Drugs are the main type of treatment for nearly everyone with multiple myeloma.
Although a single drug might sometimes be used to treat multiple myeloma, most often 2 to 4 different kinds of drugs are combined, because the cancer tends to respond better. The choice of which drugs to use depends on many factors, including:
- The traits of the myeloma (including if it’s considered high risk or standard risk)
- A person’s age, kidney function, and overall health
- If the person might get a stem cell transplant as part of their treatment
For more on some of the combinations of drugs that might be used, see Treatment Options for Multiple Myeloma and Other Plasma Cell Disorders…
Chemotherapy
Chemotherapy (chemo) is the use of certain kinds of drugs that destroy or control the growth of cancer cells. These drugs can be taken by mouth or given in a vein or a muscle. They enter the bloodstream and reach almost all areas of the body…”