Multiple Myeloma Treatment

At Moffitt Cancer Center, multiple myeloma treatment plans vary from patient to patient depending on each individual’s diagnosis, symptoms, medical history and overall health. Our Malignant Hematology Program is composed of experienced physicians from many disciplines, such as medical oncology, radiation oncology and hematopathology, and they each specialize in multiple myeloma evaluation and treatment. Together, these specialists meet in a weekly tumor board to create an individualized treatment plan for every patient.

Chemotherapy & Targeted Agents: Precision Drug Therapy for Myeloma

Chemotherapy involves the use of specialized drugs that circulate through the bloodstream to kill malignant plasma cells or prevent them from growing and dividing.

• Systemic Approach: Chemotherapy is a systemic drug therapy, meaning it affects cancer cells throughout the entire body.
• Novel Agents: While traditional chemotherapy is used, treatment for multiple myeloma often heavily incorporates newer, targeted drugs known as proteasome inhibitors (e.g., Bortezomib, Carfilzomib) and immunomodulatory drugs (e.g., Lenalidomide), which work differently than traditional chemotherapy to disrupt cancer cell function and growth.

Radiation Therapy: Targeted Relief for Myeloma Bone Pain

Radiation therapy uses high-energy X-rays to target and destroy cancer cells. Due to the systemic nature of multiple myeloma, radiation is rarely a standalone treatment but is crucial for managing localized disease:

• Bone Pain Relief: Radiation is most often administered to alleviate certain cancer-related symptoms, particularly bone pain caused by localized plasma cell buildup or bone damage.
• Localized Disease: It is often the primary treatment for a solitary plasmacytoma, a single mass of abnormal plasma cells outside the bone marrow.

If you suspect you may have myeloma, it is important to come to a high-volume program such as ours at Moffitt, so you can receive multispecialty care for this uncommon cancer.

Dr. Rachid Baz

Malignant Hematology Program

Blood and Bone Marrow Transplants: Achieving Deep, Long-Term Remission

Stem cell transplantation (commonly referred to as bone marrow transplant) is a high-dose therapy used to put the cancer into a deeper, longer remission.

• Autologous Stem Cell Transplant (ASCT): This is the most common type of transplant for multiple myeloma. The patient's own healthy blood-forming stem cells are collected and stored before high-dose chemotherapy is given. The stored cells are then returned to the patient to rebuild healthy bone marrow.
• Expert Program: Our multiple myeloma program works closely with Moffitt's dedicated Blood and Bone Marrow Transplant Program to ensure comprehensive care and management throughout this intensive procedure.

Surgery: Specialized Procedures for Bone Stabilization & Pain Management

Unlike many other types of cancer, multiple myeloma treatment typically doesn’t involve surgery, unless it has been recommended as part of a supportive care plan to alleviate the pain associated with a solitary plasmacytoma, which is a small tumor that forms when abnormal plasma cells build up within the bone or surrounding soft tissue. Furthermore, supportive care plans may include a variety of different options to help reduce any symptoms and side effects of cancer treatment. Specialists are also available to assist patients and their families with the many emotional, physical and psychological aspects of cancer care.

Clinical Trials: Accessing Next-Generation Myeloma Treatments First

As a Comprehensive Cancer Center designated by the National Cancer Institute, Moffitt Cancer Center is dedicated to developing new and effective clinical trials, providing patients with access to the cutting edge of multiple myeloma care.

Through our extensive clinical trials, patients can access novel drug combinations, new biological and targeted therapies, and next-generation treatments long before they are available in non-specialty centers.

CAR T Therapy: Harnessing Your Immune System to Fight Myeloma

CAR T-cell therapy is an advanced, highly specialized type of immunotherapy that is emerging as a powerful option for some patients with multiple myeloma. As a leader in cellular immunotherapy, Moffitt Cancer Center is at the forefront of delivering and researching this cutting-edge treatment, ensuring patients receive highly specialized care throughout the entire CAR T process.

• A Personalized Attack: The process begins with collecting a patient's own T-cells (a type of immune cell). These cells are then genetically engineered in a lab to equip them with specialized receptors (called CARs) that enable them to recognize and aggressively attack myeloma cells.
• Targeted Delivery: The modified CAR T-cells are multiplied into the millions and re-infused into the patient. Once inside the body, they act as a "living drug," immediately seeking out and destroying cancer cells wherever they reside.

Frequently Asked Questions About Multiple Myeloma Treatment

Multiple myeloma care is rapidly advancing, which is exciting, but the treatment options can sound complicated. Our specialists are here to simplify and explain the treatments discussed on this page. Below, you'll find clear answers to common questions about the goals of treatment, the role of transplants, eligibility for CAR T-cell therapy, and what each phase of your care involves.

• What is the primary goal of multiple myeloma treatment? Is it curable?

  The primary goal of multiple myeloma treatment is to achieve and maintain the deeper possible remission. While myeloma is currently considered manageable rather than curable, advances in therapies like novel agents and CAR T-cell therapy have allowed many patients to live well for extended periods. Our focus is on controlling the disease, improving quality of life, and achieving durable, long-term remission.

• Will I need to stop working or change my daily life during treatment?

  This depends heavily on your specific treatment plan and how your body responds. Many patients on oral or intravenous novel agents continue to work and lead active lives, with some adjustments. However, more intensive phases, such as stem cell transplantation (ASCT) or CAR T-cell therapy, require several weeks to months away from work and intense daily activity for monitoring and recovery. Your care team will work with you to plan for these changes and connect you with supportive resources.

• If I receive a Blood and Bone Marrow Transplant (ASCT), does that mean the treatment is over?

  No, an Autologous Stem Cell Transplant (ASCT) is a single, intensive phase of treatment designed to achieve a deep response. Following the transplant, most patients enter a maintenance phase, which involves:

  • Maintenance Therapy: Taking a lower dose of a drug (often a novel agent) for an extended period to prevent the myeloma from returning quickly.
  • Monitoring: Regular check-ups and lab work are essential to monitor your recovery and detect any signs of relapse early.
• Since multiple myeloma affects the bones, why is surgery rarely used?

  Multiple myeloma is a blood cancer that affects the bone marrow throughout the entire body (a systemic disease), so removing one area of tumor does not treat the overall disease. Surgery is reserved for supportive care only, primarily when a tumor has caused structural damage:

  • Stabilization: To repair or reinforce bones that are severely weakened and at risk of fracture.
  • Pain Relief: To surgically remove a solitary plasmacytoma causing severe localized pain.

Connect with a Moffitt Cancer Center Multiple Myeloma Specialist Today

Contact Moffitt Cancer Center by calling 1-888-663-3488 or completing our patient registration form. You do not need a referral to consult with our specialists regarding your multiple myeloma treatment.

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