Posts Tagged ‘multiple myeloma’

Treatment for Multiple Myeloma at Emory – Real Patient Story

Meet these real-life Multiple myeloma patients and learn about treatment for Multiple Myeloma at EmoryWhen Cathy Mooney was first diagnosed with multiple myeloma, the myeloma program at Winship was just beginning to take off. Today, the center provides treatment for multiple myeloma to 400 to 500 new patients a year, with about 1,600 multiple myeloma patients overall. More than 200 Winship patients participate in the Phase I Clinical Trials Unit directed by Donald Harvey.

“That’s a huge group that we are able to see in one city,” says Ajay Nooka, assistant professor of hematology and medical oncology and part of the hematology care team at Winship. In addition to caring for patients, Nooka, who specializes in cancer epidemiology, structures and oversees many of Winship’s clinical trials and assesses their outcomes.

The large patient population and high rate of clinical trial enrollment is a gold mine of data for researchers.

“The ultimate goal is to see where we stand in terms of treatment for multiple myeloma progress and what changes we can make to further improvements in patient outcomes,” Nooka says.
Another advantage for Winship’s multiple myeloma team is Atlanta’s large population of African Americans, who are twice as likely as the white population to be diagnosed with the disease.

“The difference between us and other centers is that a lot of our patients are our neighbors,” Lonial says. “A lot of the game in clinical trials is not just, are you able to do them, but do you have the patients? The growth for us has stemmed from access to new drugs and access to patients. That’s a big reason why we had four drugs approved last year as a part of treatment for multiple myeloma.”

In November, the FDA approved elotuzumab as part of an innovative immune-based therapy treatment for patients with relapsed multiple myeloma. That was the third myeloma drug approved by the FDA within the previous month and the fourth approved within the last year.

That’s good news for patients like Quincy Washington, who was 42 when he was diagnosed with multiple myeloma in 2007.

At first his doctor suspected rheumatoid arthritis, but then sent Washington to an oncologist, where he learned about myeloma for the first time. The disease typically strikes African American men at a younger age than any other patient group.

“The doctor said, you have multiple myeloma. I said, okay. What do we do next?” Washington remembers. “She looked at my wife and said, is he in shock? And my wife said no, that’s pretty much his personality. I don’t really do the whole gloom-and-doom perspective.”

Washington happened to have a friend who specializes in oncology at Winship, and that’s how he discovered that he could get the most leading-edge care within miles of his home in Lithonia. He began treatment for multiple myeloma immediately, including enrollment in a clinical trial.

Now in long-term remission, Washington says, “My plan is to be cured. At some point, my numbers will be zero. When it comes to age, I’m a triple-digit kind of guy.”

Treatment for Multiple Myeloma at Emory – Real Patient Story

myeloma_mooney_coverCathy Mooney shares her multiple myeloma patient story. Treatment for multiple myeloma is the topic very relevant to even those who consider themselves a “health nut” or a “gym rat”. This article shares a story of how one health-conscious young lady had to undergo a treatment for multiple myeloma at Emory.

Cathy Mooney didn’t need a wake-up call. In 2002, at 48 years old, “I felt like I was at the top of my game,” she says. “I was exercising regularly, walking four miles five days a week. I was following a great diet. I had really never been in better health.” But a routine physical exam turned up some troubling results, and a long series of visits to specialists and tests followed. After a frustrating three months, Mooney heard two words she never knew before: multiple myeloma.

“I learned that the survival rate was three to five years,” she says. “We were devastated. I felt wonderful; I did not feel sick.” Mooney received an advise to travel from her home in Thomasville, Georgia, to Little Rock, Arkansas. There was a center specializing in myeloma.

For several years she received the following treatment there:

  • chemotherapy
  • autologous stem cell transplantation
  • maintenance medications

Although her cancer could be coaxed into remission, it kept coming back.

In 2008, Mooney and her husband flew north to visit myeloma specialists at Sloan Kettering and the Dana-Farber Cancer Institute. The latter was Ken Anderson, who had been following Lonial’s progress at Winship. Both told Mooney that she could get the best, most current treatment in her home state of Georgia.

“When we went to Emory and met with Dr. Lonial and his team, we found him to be a compassionate person who cared and was passionate about finding a cure for multiple myeloma,” Mooney says. “He’s such a respected doctor in this field, one of the top in leading research and a rising star.”

Since Mooney’s diagnosis, her twin daughter and son have married and had children of their own. Her five grandchildren are a constant delight.

“This year was 14 years since my diagnosis, which is a lot more than I hoped for,” she says. “I’m feeling great. The cancer has given me an opportunity to reassess my life and set new priorities. And Winship gives me hope for a bright future.”

Multiple Myeloma Symptoms & Treatment – Real Patient Story

Meet Emory's real Multiple myeloma patient and learn about Multiple myeloma symptoms and treatment optionsMultiple myeloma begins in the bone marrow with plasma cells going haywire. This article shares a multiple myeloma patient story, as well as discusses symptoms and treatment options.
Seven years ago, Tamara Mobley was so busy, active, and energetic that if she were a cartoon, she’d be a blur. The dedicated mother of two young boys, a loving wife and a full-time employee in a good job, she didn’t get much downtime.

“I think I was just busy, like any other typical mom,” Mobley says. “You know, just doing things to take care of the house, my family and doing my best to be a valued employee. That was my life before, just ripping and running.”

Then Mobley, who was 33, got tired. Not just garden-variety, too-little-sleep, I’ve-been-doing-too-much sort of tired. But bone tired, from the moment she woke up each morning. Then, there was the severe back pain. And then, the passing out. She was getting sick and it was happening fast. For a young, vibrant, working wife and mother that was terrifying.

A trip to the emergency room led to a rapid diagnosis of multiple myeloma — a cancer of the blood — and a recommendation from her doctor to seek treatment at Emory and Winship.
Mobley was so ill that she got to Emory University Hospital in an ambulance. And that’s when all the ripping and running slowed way, way down — at least for a while.

Multiple Myeloma Symptoms

As cancer goes, multiple myeloma is a bit of a misfit.

For one thing, it’s rare. The American Cancer Society estimates that about 30,000 new cases of myeloma will be diagnosed this year, trailing far behind the most common cancers — breast and lung — each of which will derail more than 220,000 lives. That’s stiff competition for research funding and awareness.

For another, it’s mysterious. Multiple myeloma begins in the bone marrow with plasma cells going haywire. But experts aren’t entirely sure how the process starts or what the key risk factors are. The disease is most common in people over 65, men are slightly more vulnerable and that African Americans are more than twice as likely as white Americans to get it. But we don’t know why.
The most notable differ
ence between multiple myeloma and pretty much all other types of cancer is that the life expectancy for myeloma patients has doubled in the past decade. All thanks to treatments developed and tested at Emory’s Winship Cancer Institute.

Multiple Myeloma Treatment

Last November, the US Food and Drug Administration (FDA) approved the fourth new myeloma drug to be green-lighted within one year —three of those within one monthv—and all four were tested in clinical trials at Winship.

“There’s no other story like that in cancer,” says Sagar Lonial, Winship’s chief medical officer and chair of the Department of Hematology and Medical Oncology in the School of Medicine.
Since his arrival at Emory and Winship in 1997, Lonial has built the multiple myeloma program into one of the best and most sought-after in the country. A team of experts who specialize in the disease leads this program. As Georgia’s only National Cancer Institute–designated cancer center and one of just 69 in the US, Winship offers patients the chance to be treated in the same building where research is taking place. There are three floors dedicated to basic science and three to clinical care.

“That marriage of research and patient care is powerful,” Lonial says. “Our scientists see cancer patients every day.”

One of those is Mobley, who has been in treatment at Winship since that devastating ambulance ride in 2009. Once her condition was stabilized, she began the standard protocol. It consists of a three-pronged attack:

  • Chemotherapy to blast away the cancerous cells
  • Stem cell harvesting and transplantation to regenerate healthy bone marrow cells
  • Regimen of medications calibrated to keep the cancer at bay and send it into remission for a long time.

It’s that last phase that has put Winship’s approach ahead of other myeloma treatment centers. Instead of a one-by-one, trial-and-error approach to drug therapy, Lonial has advocated a full court press. It allowed to hit the residual cancer with a simultaneous three-drug combination.

Mobley was put on an aggressive course of therapy made up of

  • Lenolidamide (Revlimid), an immune modulator
  • Bortezomib (Velcade), a proteasome inhibitor
  • Dexamethasone, a corticosteroid

“That concept of combination therapy is one that our center is focused on and one that benefited her early on,” Lonial says.

According to myeloma researcher Lawrence Boise, Georgia Cancer Coalition Distinguished Cancer Scholar and coleader of the Cancer Cell Biology Program at Winship, scientists are finding that there are many reasons for this. But the most compelling is that it works. “Dr. Lonial doesn’t leave any bullets in the chamber,” Boise says. “In all the trials, all the data, all the comparisons show that three drugs are better than two.”

When Lonial joined Emory’s hematology and oncology department nearly two decades ago, other researchers might have seen a department struggling with turnover and inadequate resources. With the encouragement of a mentor—Kenneth Anderson, probably the best-known myeloma specialist in the world—Lonial saw an opportunity to build a program, from the ground up.

The bottom floor of Winship houses the Clinical Trials Unit, the key to the multiple myeloma program’s growth and success. Within a few years, Lonial had recruited top scientists and clinicians, including Boise, and was testing new classes of drugs in Phase I clinical trials. They proved to be game changers.

Multiple myeloma is a cancer of the blood that develops when normal, antibody-producing plasma cells become malignant and their growth spirals out of control. They build up in the bone marrow until they crowd out healthy blood cells. They can form lesions and tumors in multiple bones, hence the condition’s name.

But the cancerous cells also secrete protein and, like normal cells, they’re engineered to do this in a particular way—the protein assembled and folded just so. When that assembly goes awry, as it does in myeloma cells, the malformed proteins are broken down by proteasomes—protein complexes whose job it is to get rid of problem proteins by degrading them—and that opens up the pipeline for more myeloma cell production.

About ten years ago, scientists discovered that if you interfere with the proteasome’s work—allowing the abnormal proteins to accumulate—the cancerous cells, which in a sense are trying to function normally, will self-destruct. Rapidly.

“Proteasome is part of quality control, so if you inhibit that, and all these mid-folded proteins build up, that causes stress, and the cell kills itself,” Boise explains.

Winship conducted trials of a promising proteasome inhibitor, bortezomib (Velcade), in 2002. One of the first patients to receive it went into remission quickly. “If there was a moment when the light went on, it was then. I remember running upstairs to the director’s office with the graph of this patient’s counts,” Lonial says. “That treatment is now the standard of care.”

Learn more about Tamara’s story here.

Winship key to four new myeloma drugs in 2015

lonial patientThe U.S. Food and Drug Administration (FDA) approved elotuzumab as part of an innovative immune-based therapy treatment for patients with relapsed multiple myeloma. This is the third myeloma drug approved by the FDA within the last month and the fourth new myeloma treatment approved within the last year. All four new agents were tested in clinical trials at Winship Cancer Institute of Emory University.

Sagar Lonial, MD, chief medical officer of Winship, says the potential of elotuzumab can be seen in the overall response rate as well as the longer duration of progression-free survival.

“The Winship multiple myeloma team has shepherded several of these treatments from the beginning stages of testing through to their approval,” said Lonial. “It’s a great source of pride to know we were instrumental in the process that has led to many more treatment options for our patients.”

Read the full press release here.

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Landmark Multiple Myeloma Studies from Winship

In recognition of September being Blood Caner Awareness Month, Dr. Sagar Lonial, Winship’s Chief Medical Officer shares a video about his Winship phase III clinical trial study on elotuzumab in treating myeloma patients.

Many cancers have benefited from FDA approvals for monoclonal antibodies (mAbs). Multiple myeloma, a second common blood cancer, had limited outcome improvements with mAbs until Dr. Lonial’s recent work. Dr. Lonial’s research was presented at the 2015 American Society of Clinical Oncology (ASCO) Annual Meeting and was published in the New England Journal of Medicine earlier this year.

Learn more about Winship Cancer Institute of Emory University.

How We’re Working to Cure Multiple Myeloma

Over the past ten years, I have seen the treatment of multiple myeloma dramatically improve because of new drug therapies that have come out of clinical trials. I am now leading a clinical study to learn more about the genetic components of multiple myeloma and how we can use that knowledge to come up with better, more targeted drugs and individualized therapies for patients. I think this landmark study will lead to treatments that effect long-term remission, or even cure, from the cancer.

In the CoMMpass study, launched by the Multiple Myeloma Research Foundation, we will follow 1,000 newly diagnosed patients with multiple myeloma over the course of eight years. We will study the genomic changes in their disease while they receive frontline treatments, and continue studying those changes through remission stages or relapse. One of the questions we hope to answer is why some patients do well on a specific drug, while others do not and may need multiple drugs to keep their myeloma from advancing.

The first step in the study is mapping out the molecular characterization of a patient’s tumor using sequencing at the time of initial diagnosis, and then following what happens in the sequencing information during and after treatment. If the disease comes back, we want to know if there were changes in the disease or new mutations that were influenced by the therapy or by the original mutations themselves?

As we learn more about cancer and its various types, we do less lumping them together and more splitting them into individual diseases. Lymphoma is a good example. It used to be that the disease was characterized as six or seven different types, and now we know there are at least 50 different variations of lymphoma. We look at the molecular characterization of lymphoma and create subtypes that are potentially treated in different ways. We may need to do that in myeloma. In the CoMMpass study, we will be able to have individual tumor specimens molecularly sequenced, which has never been done before, and we will learn much more about the cancer and its number of subtypes.

We are also looking at the impact of side effects on quality of life issues in this trial. There may be molecular characteristics of a patient’s tumor that can tell us whether that patient will have side effects from a specific treatment, so mapping a patient’s molecular subtype might influence the type of drugs he gets.

We have seen the life expectancy of multiple myeloma patients double in the last ten years. I think that there are probably some patients we are curing now and I believe that CoMMpass will help us to identify the best drugs and the best targets to increase the cure rate in this disease. We hope this study will help push the barrier to cure even further, but do it in a way that does not compromise a patient’s quality of life.

To learn more, watch this video as Dr. Lonial further explains Multiple Myeloma and treatment options for the diease.

Multiple Myeloma Online Chat

Multiple Myeloma Chat Sign UpWant to learn more about multiple myeloma? Join expert physician, Jonathan Kaufman, MD, for a live web chat on March 11, 2014 at 12:00 PM EST. Dr. Kaufman will be there to answers all your questions about known risks, prevention, diagnosis and treatment of multiple myeloma. Bring your questions and prepare for a great discussion!

Multiple Myeloma Chat Sign Up

About Dr. Sagar Lonial

Dr. Sagar LonialDr. Lonial is Vice Chair of Clinical Affairs for the Department of Hematology and Medical Oncology at the Winship Cancer Institute of Emory University, and Director of the Translational Research for the B-Cell Malignancy Program. He is also a professor in the Emory University School of Medicine.

Dr. Lonial’s research focuses on combination therapy in B-cell malignancies focusing on myeloma. He is a trained bone marrow transplant physician with an interest in molecular therapy for lymphoma and myeloma. His clinical interests include evaluating the combination of new molecular targeted agents for B-cell tumors as well as target discovery and validation.

Dr. Lonial has authored or coauthored over 200 publications and recently was awarded the Celgene ‘Young Investigator’ Award, the MMRF ‘Top 15 Innovator’ Award, and the MMRC ‘Center of the Year’ award.

He earned his medical degree from the University Of Louisville School Of Medicine. He completed his internship and residency at Baylor College of Medicine in Houston, Texas, followed by a fellowship in Hematology/Oncology at Emory University School of Medicine in Atlanta, Georgia.

Related Links
Understanding Multiple Myeloma
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Understanding Multiple Myeloma

While still a relatively uncommon cancer, multiple myeloma has recently received attention surrounding the diagnosis of popular news reporter, Tom Brokaw. This year, an estimated 24,000 people in the United States will be diagnosed with multiple myeloma, and there are about 77,600 people now living with this blood cancer.

About Multiple Myeloma

Multiple myeloma is a type of cancer that forms because of a disorder in the plasma cells, which live in the bone marrow and are the producers of antibodies. These antibodies are what provide protection from infections after vaccination, but in myeloma, the plasma cells become malignant and grow out of control, crowding out the normal bone marrow.

When plasma cells grow uncontrolled by the normal immune system, the consequences can include:

  • Anemia, a condition caused by low red blood cell counts due to crowding in the bone marrow.
  • Bone lesions, as myeloma cells like to create “holes” in the bones.
  • Kidney problems, because the antibodies produced by the plasma cells can clog up the kidneys.
  • Elevated blood calcium level, typically as a consequence of the bone issues.

Multiple Myeloma Symptoms

The most common symptoms for patients are typically fatigue, weakness, bone pain, anemia, or frequent unexplained infections. Multiple myeloma affects both men and women but is more common in men and there is a higher occurrence of multiple myeloma among African Americans than among Caucasians.  It is a disease typically seen in patients who are older than age 65, although it occurs in African-American patients about ten years earlier, and it affects a fair number of younger patients.

Multiple Myeloma Treatment

Treatment for patients with multiple myeloma has changed dramatically over the past decade. As we have developed more effective drugs to target the plasma cells, we also have significantly improved overall survival. Fifteen years ago, the average survival was 3 to 4 years, whereas the average survival is now over 7 years, and for many patients, expected survival is more than 10 years.

The keys to this improvement in overall survival are related to several factors. First, we have better tools to combat myeloma. There have been 6 new drugs approved for treating myeloma over the past decade, and these agents are more effective at treating the disease than the standard mixtures of chemotherapy we had before. The second factor that has improved survival for certain patients is the use of high-dose chemotherapy and autologous stem cell transplantation, in which the patient’s own stem cells are given back to the patient’s body after receiving high-dose chemotherapy. Finally, we now have a better understanding of the biological changes that occur in a myeloma cell and this is helping us to better target treatment needed among these patients.

As we discover new tools and expand the options available for treating multiple myeloma, we see encouraging advancements in both survival and quality of life for these patients. The multidisciplinary treatment team at Winship at Emory has been recognized as a national and international leader in both transplant and non-transplant based approaches to treatment therapies, patient outcomes and clinical trials.

Multiple Myeloma Online Chat

Multiple Myeloma Chat Sign UpWant to learn more about multiple myeloma? Join expert physician, Jonathan Kaufman, MD, for a live web chat on March 11, 2014 at 12:00 PM EST. Dr. Kaufman will be there to answers all your questions about known risks, prevention, diagnosis and treatment of multiple myeloma. Bring your questions and prepare for a great discussion!

Multiple Myeloma Chat Sign Up

About Dr. Sagar Lonial

Dr. Sagar LonialDr. Lonial is Vice Chair of Clinical Affairs for the Department of Hematology and Medical Oncology at the Winship Cancer Institute of Emory University, and Director of the Translational Research for the B-Cell Malignancy Program. He is also a professor in the Emory University School of Medicine.

Dr. Lonial’s research focuses on combination therapy in B-cell malignancies focusing on myeloma. He is a trained bone marrow transplant physician with an interest in molecular therapy for lymphoma and myeloma. His clinical interests include evaluating the combination of new molecular targeted agents for B-cell tumors as well as target discovery and validation.

Dr. Lonial has authored or coauthored over 200 publications and recently was awarded the Celgene ‘Young Investigator’ Award, the MMRF ‘Top 15 Innovator’ Award, and the MMRC ‘Center of the Year’ award.

He earned his medical degree from the University Of Louisville School Of Medicine. He completed his internship and residency at Baylor College of Medicine in Houston, Texas, followed by a fellowship in Hematology/Oncology at Emory University School of Medicine in Atlanta, Georgia.

Winship Cancer Institute Recognized for “Exceptional Contributions” to Advancing Research and Treatment of Multiple Myeloma

A team of researchers from Winship Cancer Institute of Emory University has been awarded the Multiple Myeloma Research Foundation (MMRF) Accelerator Award. The award recognizes Sagar Lonial, MD, Jonathan Kaufman, MD, Ajay Nooka, MD, MPH, Lawrence Boise, PhD and Leon Bernal-Mizrachi, MD, for their “outstanding efforts and exceptional contributions to starting new clinical trials supported through the Multiple Myeloma Research Consortium (MMRC) and rapidly enrolling patients in those trials.”

Emory researchers receive MMRF award

From left to right: Beverly Harrison, Vice President of Clinical Development at the MMRC, Dr. Leon Bernal-Mizrachi and Dr. Jonathan Kaufman of Winship Cancer Institute of Emory University, and Walter M. Capone, Chief Operating Officer of the MMRF.

The MMRC is a non-profit organization that brings together 16 leading academic institutions with a focus on accelerating drug development in multiple myeloma. Out of the 16 institutions, Winship earned best overall performance for 2013. In addition to these honors, Lonial was recognized for his exceptional leadership of the MMRC Steering Committee, PRC and the MMRF CoMMpass℠ Study Steering Committee.

Support Changes & Saves Lives for Bone Marrow Transplant Patients

William Fuentes, a father of two pre-schoolers and a manager at a McDonald’s, had a very busy life in Calhoun, Georgia, one of Atlanta’s northern suburbs. While his wife took care of the little ones, he still tried to help out around the house while managing the duties of a busy restaurant.

William’s busy life only got more complicated when the 30-year-old was diagnosed in 2012 with multiple myeloma, a disease he had never even heard of. The intense back pain he felt turned out to be a result of the disease. He was rushed to the hospital in an ambulance, and then he had to have surgery to repair some of the damage in his back.

And then treatment started. He needed a bone marrow transplant, often a complicated procedure best handled by a team that has a breadth and depth of experience to handle complications that may arise. He turned to the Emory Bone Marrow & Stem Cell Transplant Center of the Winship Cancer Institute of Emory University.

William Fuentes Multiple Myeloma Bone Marrow Transplant Patient

William Fuentes with his family.

William recalls being so afraid and yet wanting to be strong for his children. After they would go to sleep at night, sometimes he cried, he said.

“I just felt so all alone,” William recalls.

But he found the support he received from Winship and the Bone Marrow & Stem Cell Transplant Center not only saved his life, but changed his life. Enrollment in a clinical trial gave him access to a drug that worked on his type of myeloma, something he may not have received had he been treated elsewhere. Equally important to him was the compassionate care he received from his physician, Dr. Ajay Nooka, and the bone marrow transplant team.

“He is the nicest man I’ve ever met,” William said. “I couldn’t have asked for better treatment,” he says. Winship social workers made sure gas cards were available when funds ran low. A team of employees from the clinical trials unit came together and provided Christmas gifts for the Fuentes family.

“My wife is so thankful. We love it here,” says William.

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