New Drug Combinations Research

Doctors are combining bortezomib with a number of new drugs to increase their effectiveness. One of the most promising combinations is bortezomib and lenalidomide. Both drugs destroy myeloma cells in distinct ways. For most people with advanced multiple myeloma, this combination slows cancer growth, even if either drug failed to slow the cancer growth on its own. When dexamethasone is added to the mix, the drugs work in virtually all people with multiple myeloma, with most experiencing a complete remission.

Future treatments in research:

Some of these new medications to treat multiple myeloma include:

Monoclonal Antibodies

Often compared to guided missiles, monoclonal antibodies zero in on cancer cells whose surfaces harbor a “target molecule.” HuLuc63 is one member of this class of drugs; it is being studied for use as a treatment by itself or in combination with other medications such as dexamethasone and bortezomib. HuLuc63 zeroes in on myeloma cells containing a substance called CS1, which myeloma cells produce at a higher rate than healthy cells. Another monoclonal antibody CNTO 328 inhibits interleukin-6, a growth factor for myeloma cells.

Growth Blockers

These drugs are designed to block the growth of myeloma cells by depriving them of substances they need, such as vascular endothelial growth factor (VEGF). When tumor cells spread through the body, they release VEGF to create new blood vessels. These blood vessels supply oxygen, minerals, and other nutrients to feed the tumor. Another promising drug in this class is designed to block a protein called ERK, which is also a substance that myeloma cells need to grow.

Proteasome Inhibitors

Three different proteasome inhibitors have shown promise in clinical trials. Bortezomib was the first. NPI-0052, a new proteasome inhibitor, seems to block the actions of proteasomes more broadly than does the drug bortezomib. Carfilzomib appears to work the same way as bortezomib, only more strongly.


A new form of the drug thalidomide is showing promise in people whose multiple myeloma has returned after previous treatment. Called pomalidomide, this medication stops the growth of blood vessels that feed tumors. It also boosts the immune system and may kill cancer cells directly.

Telomerase Inhibitors

One drug, known as GRN163L, blocks an important enzyme found to be active in myeloma cells. This enzyme allows cancer cells to resist chemotherapy.

Importance of Clinical Trials

These newest drugs may become available through clinical trials based at Vancouver General Hospital Leukemia Bone Marrow Transplant program or the BC Cancer Agency.

Clinical trials are a critical part of the research process that advances research into a new treatment choice. The more people who enter a clinical trial the faster critical research questions can be answered that will lead to better treatment. Only after new drugs go through the drug trial process are they submitted to Health Canada for possible use. So the more clinical trials, the more people participating in them, the sooner new treatments for myeloma and disease-related problems will become available.

There are risks and benefits to clinical trials. Discussion with your haematologist/oncologist will determine if this is an option for you.