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Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.
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Myeloma Chemo Testing
Myeloma chemo testing, that is to say, testing your specific myeloma to see if it is sensitive to Velcade, Revlimid, Daratumumab, etc. could be a major breakthrough in managing the blood cancer multiple myeloma.
Most importantly, MM patients can respond to induction, ASCT and maintenance therapy very differently, from only living a year or two up to living more than 10 years and beyond.
I believe that myeloma chemotherapy testing, as described by the article linked below, is a possible solution to these treatment issues.
To be clear, the article linked below is talking about testing the individual for ALL types of drugs. Because I am a MM survivor, I am focusing this post exclusively on myeloma chemo testing.
What is chemotherapy drug testing? The way chemo drug testing is conduction today.
Stages of Chemotherapy Drug Testing
- Preclinical Testing:
- In Vitro Testing: Involves testing the drug on cancer cell lines in a laboratory. Researchers assess how effectively the drug kills cancer cells or inhibits their growth. This stage also involves studying the drug’s mechanism of action and its effects on cellular pathways.
- In Vivo Testing: Involves testing the drug on animal models to study its effects on tumors within a living organism. This helps in understanding the drug’s pharmacokinetics (how the drug is absorbed, distributed, metabolized, and excreted) and pharmacodynamics (the drug’s effects on the body).
- Clinical Trials:
- Phase I Trials: Test the drug on a small group of people (20-80) to evaluate its safety, determine a safe dosage range, and identify side effects.
- Phase II Trials: Involve a larger group of people (100-300) to further evaluate the drug’s effectiveness and safety.
- Phase III Trials: Involve large groups of people (1,000-3,000) to confirm the drug’s effectiveness, monitor side effects, compare it with commonly used treatments, and collect information that will allow the drug to be used safely.
- Phase IV Trials: Conducted after the drug has been approved for public use. These trials gather additional information on the drug’s long-term effectiveness, benefits, and any side effects.
Key Aspects of Chemotherapy Drug Testing
- Efficacy: Determining how well the drug works in killing or stopping the growth of cancer cells.
- Safety: Assessing the side effects and potential risks associated with the drug.
- Dosage: Establishing the appropriate dosage that maximizes efficacy while minimizing adverse effects.
- Mechanism of Action: Understanding how the drug works at a molecular level.
- Combination Therapies: Evaluating how the drug interacts with other treatments, such as surgery, radiation, or other chemotherapy agents.
Importance of Chemotherapy Drug Testing
- Personalized Medicine: Helps in identifying which patients are most likely to benefit from the drug based on genetic and molecular profiles.
- Drug Development: Essential for the development of new and more effective cancer treatments.
- Regulatory Approval: Required for gaining approval from regulatory bodies like the FDA to ensure that the drug is safe and effective for public use.
The drug testing process outlined above focuses on a drug candidate and a group of people. Or in the case of multiple myeloma, testing a drug to see how a group of MM patients respond.
The gene testing discussed below would be able to test an individual MM patient and determine efficacy and susceptibility to side effects of a given chemotherapy.
My interpretation of the article below is that this form of gene testing is relatively new. In my experience this means that it is up to the individual MM patient (you) to ask your oncologist about a test to evaluate your MM accordingly. And then you have to figure out if your health insurance will cover the testing.
It doesn’t sound as though myeloma chemotherapy testing is easy at this point. However, if you can do it, it may be well-worth it.
What do you know about any form of myeloma chemo testing? Have you tried “The Greek Test” or “RGCC test?” If so, what were the results? The testing will have to be FDA approved. A foreign company will not be FDA approved.
Let me know at David.PeopleBeatingCancer@gmail.com
Thank you,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
New Gene Tests Can Predict if a Drug Will Work for a Patient
“What if there were tests that could tell you whether the following drugs were a good match for your patients: Antidepressants, statins, painkillers, anticlotting medicines, chemotherapy agents, HIV treatments, organ transplant antirejection drugs, proton pump inhibitors for heartburn, and more?
That’s quite a list. And that’s pharmacogenetics, testing patients for genetic differences that affect how well a given drug will work for them and what kind of side effects to expect.
“About 9 out of 10 people will have a genetic difference in their DNA that can impact how they respond to common medications,” said Emily J. Cicali, PharmD, a clinical associate at the University of Florida College of Pharmacy, Gainesville, Florida.,,
Genetic factors are thought to contribute to about 25% or more of inappropriate drug responses or adverse events, said Kristin Wiisanen, PharmD,..
“Pharmacogenetics helps consumers avoid drugs that may not work well for them or could cause serious adverse events. It’s personalized medicine,” Cicali said…
Through a cheek swab or blood sample, the MyRx program — and a growing number of health system programs, doctors’ offices, and home tests available across the United States — gives consumers a window on inherited gene variants that can affect how their body activates, metabolizes, and clears away medications from a long list of widely used drugs…
Why PGx Tests Can Have a Big Impact
These tests work by looking for genes that control drug metabolism.
“You have several different drug-metabolizing enzymes in your liver,” Cicali explained. “Pharmacogenetic tests look for gene variants that encode for these enzymes. If you’re an ultrarapid metabolizer, you have more of the enzymes that metabolize certain drugs, and there could be a risk the drug won’t work well because it doesn’t stay in the body long enough. On the other end of the spectrum, poor metabolizers have low levels of enzymes that affect certain drugs, so the drugs hang around longer and cause side effects.”
While pharmacogenetics is still considered an emerging science, it’s becoming more mainstream as test prices drop, insurance coverage expands, and an explosion of new research boosts understanding of gene-drug interactions, Wiisanen said…
“The use of pharmacogenetic data to guide prescribing is growing rapidly,” Wiisanen said. “It’s becoming a routine part of drug therapy for many medications…”
What the Research Shows
When researchers sequenced the DNA of more than 10,000 Mayo Clinic patients, they made a discovery that might surprise many Americans: Gene variants that affect the effectiveness and safety of widely used drugs are not rare glitches. More than 99% of study participants had at least one. And 79% had three or more.
The Mayo-Baylor RIGHT 10K Study — one of the largest PGx studies ever conducted in the United States — looked at 77 gene variants, most involved with drug metabolism in the liver. Researchers focused closely on 13 with extensively studied, gene-based prescribing recommendations for 21 drugs including:
- antidepressants,
- statins,
- pain killers,
- anticlotting medications for heart conditions,
- HIV treatments,
- chemotherapy agents,
- and antirejection drugs for organ transplants.
When researchers added participants’ genetic data to their electronic health records, they also sent semi-urgent alerts, which are alerts with the potential for severe harm, to the clinicians of 61 study volunteers. Over half changed patients’ drugs or doses…
PGx checks are already strongly recommended or considered routine before some medications are prescribed…
“One of the key benefits of pharmacogenomic testing is in preventing adverse drug reactions,” Wiisanen said. “Testing of the thiopurine methyltransferase enzyme to guide dosing with 6-mercaptopurine or azathioprine can help prevent myelosuppression, a serious adverse drug reaction caused by lower production of blood cells in bone marrow…”
Companies that offer the tests include ARUP Laboratories, Genomind, Labcorp, Mayo Clinic Laboratories, Myriad Neuroscience, Precision Sciences Inc., Tempus, and OneOme, but there are many others online. (Keep in mind that many laboratories offer “lab-developed tests” — created for use in a single laboratory — but these can be harder to verify. “The FDA regulates pharmacogenomic testing in laboratories,” Wiisanen said, “but many of the regulatory parameters are still being defined.”)…
Because PGx is so new, there is no official list of recommended tests. So you’ll have to do a little homework…
Consider Cost
The price tag for a test is typically several hundred dollars — but it can run as high as $1000-$2500. And health insurance doesn’t always pick up the tab.
In a 2023 University of Florida study of more than 1000 insurance claims for PGx testing, the number reimbursed varied from 72% for a pain diagnosis to 52% for cardiology to 46% for psychiatry…
Understand the Results
As more insurers cover PGx, Klein and Wiisanen say the field will grow and more providers will use it to inform prescribing. But some health systems aren’t waiting.
In addition to UF Health’s MyRx, PGx is part of personalized medicine programs at the University of Pennsylvania in Philadelphia, Endeavor Health in Chicago, the Mayo Clinic, the University of California, San Francisco, Sanford Health in Sioux Falls, South Dakota, and St. Jude Children’s Research Hospital in Memphis, Tennessee…”