Refining Multiple Myeloma Treatments: the EMMA Created at Moffitt
Multiple myeloma is heterogenous, with its behavior varying widely from patient to patient. While not considered curable, the disease follows a relapsing remitting course. Some patients may enjoy a long survival often exceeding a decade (and the disease can be considered a chronic illness) while others will have a more acute course with early disease refractoriness and a short survival.
The outlook for patients has improved over the past few decades, and this will likely improve even further with contemporary and novel therapies making a cure a possible goal of therapy.
One of the most cutting-edge technologies driving progress toward better patient responses and, ultimately, a cure for multiple myeloma is a tool developed by Moffitt as a result of a generous gift from a donor, Mark Pentecost, who is a Moffitt Cancer Center multiple myeloma patient himself.
The Pentecost Family and the Development of EMMA
After a surprising multiple myeloma diagnosis, Mark Pentecost, founder of health company It Works!, traveled the country seeking additional medical opinions, but ultimately opted to start therapy at Moffitt under the care of Dr. Rachid Baz, MD, section head of Myeloma in Moffitt’s Department of Malignant Hematology. He subsequently underwent a stem cell transplant. . He then began a maintenance program, which has stabilized his disease for the past six years.
Throughout his time as a Moffitt patient, Pentecost built a close relationship with the Multiple Myeloma Program. In 2018, the Pentecost family donated $3 million to the program, which accelerated the development of of the Ex Vivo Mathematical Myeloma Advisor (EMMA), a new personalized medicine tool developed by Dr. Kenneth Shain and Dr. Ariosto Silva.
The Ex Vivo Mathematical Myeloma Advisor (EMMA)
EMMA provides personalized therapy recommendations for multiple myeloma care by testing a patient’s multiple myeloma sensitivity to dozens of drugs concurrently, both individually and in combination.
Using a small sample of a multiple myeloma patient’s bone marrow biopsy, researchers administer 31 different drugs to the isolated multiple myeloma cells. Over the next five days, powerful digital microscopes snap live images every 30 minutes to document the cells’ reactions.
Using mathematical models specific to each patient and drug alongside the digital imagery collected by the microscopes, EMMA predicts patient responses to potential therapies, producing a three-month prediction and recommendations for the best course of treatment.
The goal of EMMA is to eliminate the need for a trial-and-error methodology through a personalized medicine tool. Moreover, its potential extend far beyond an individual patient’s benefit, with the hope that the data collected can be used cumulatively by doctors and researchers to better understand how the disease evolves, including what drives and slows its progression. Eventually, the data could be used to develop new therapies and drugs or to design a clinical trial for a specific patient subtype.
The Future of Multiple Myeloma Research and Therapies
Following the donation that led to EMMA, the Pentecost family made a second, generous transformational gift of $10M to establish the Pentecost Family Myeloma Research Center at Moffitt. The Center’s mission is to leverage expertise across the cancer center to find a cure for the disease by 2032. Today, the research center is exploring better ways to predict which patients are at the highest risk for developing multiple myeloma as well as utilizing clinical trials to accelerate drug discovery and determine individualized treatment sequencing.
The hope is that more patients will be able to receive curative intent therapy to end the cycle of remissions followed by relapse or develop enough ways to stabilize it long enough for patients to live long, happy lives.
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