Multiple Myeloma is a type of cancer which can be found in the plasma cells of bone marrow. These cells are responsible for producing antibodies which help the body fight infection. However, when a plasma cell begins to behave abnormally and undergoes a change, it may begin to stop producing these helpful antibodies. Instead, it will start multiplying itself into more abnormal plasma cells.
Lots of these abnormal cells lumped together form a cancerous tumor, and since they are found inside bones, this can cause damage to the body. Common risks of multiple myeloma include kidney, bone and immune system damage.
Because of the hard-to-treat nature of multiple myeloma, medical scientists have been researching many different methods of treating it. Proteasome inhibitors are a leading type of therapy in the field. They work by preventing cancer cells from disposing of the used proteins which build up inside of them. Eventually, the cancer cell becomes too full of these used proteins, resulting in cell death, known as apoptosis.
Two such proteasome inhibitors used to treat multiple myeloma include carfilzomib (Kyprolis) and ixazomib (Ninlaro).
Ninlaro was approved by the FDA in the U.S. in 2015. It is the world’s first and only orally-administered proteasome inhibitor. This makes it easy for patients to take at home and is not as daunting or uncomfortable as an injection. When paired with lenalidomide (Revlimid) and dexamethasone, average progression-free survival (meaning the amount of time a patient will survive with the disease without it getting worse) is about 20.6 months – an increase of nearly 6 months. Typically, Ninlaro is only given to patients who have received one other line of treatment beforehand. Common side effects include gastrointestinal issues – diarrhea, constipation, and nausea – as well as back pain and bodily swelling.
Kyprolis, on the other hand, is given as an intravenous (IV) infusion, meaning that it is injected into the veins in a clinic or hospital. It can be given alone, in combination with dexamethasone or in combination with both dexamethasone and lenalidomide (Revlimid) just like Ninlaro. A clinical study showed that the median progression-free survival of patients who took Kyprolis with dexamethasone was 47.6 months. It is made by Onyx Pharmaceuticals. According to the Multiple Myeloma Research Foundation, common side-effects include tiredness, low red blood cell count, nausea, diarrhea and difficulty breathing.
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