Myeloma is an incurable cancer of the haematopoietic system. Nevertheless, thanks to new drugs, it is possible to successively extend the life expectancy of patients. Progress is most evident in the United States, where patients already live 5-7 years after diagnosis. Unfortunately, in Poland this average fluctuates only around 4-4,5 years. The lack of access to modern therapies is to blame for everything.
“The priority in Poland should be to include deratumumab and pomalidomide in the treatment” – said prof. Grzegorz Mazur during the Lymphoma & Myeloma congress in New York.
The first of these agents is a monoclonal antibody which selectively binds to antigens located on the surface of tumor cells. As a result, the drug only destroys the cancerous tissue, and therefore the treatment has very few side effects.
“I am a supporter of targeted therapies” – said prof. Mazurka. “We used to give myeloma patients chemotherapy after which they had very severe side effects, such as vomiting. Today we can avoid it ».
The second of these drugs, pomalidomide, is a third generation immunomodulating drug (after thalidomide and lenalidomide). It is already available in many European countries when patients have developed resistance to lenalidomide and can no longer be successfully treated with it.
Unfortunately, although pomalidomide is already registered in Poland, there are no signs that myeloma patients in Poland will soon have access to the third generation drug. It is still unclear whether lenalidomide (a second-generation drug) alone will be present in the therapy. The drug program under which it can be used ends on November 1 this year and it is still unclear under what conditions it will be extended.
It is worth mentioning that over the last two years, lenalidomide, which is already very easily available in Europe, has been used in Poland as a second-line treatment agent. This means that only in patients in whom thalidomide caused the development of peripheral polyneuropathy, the more advanced method was introduced. Doses of 5, 10, 15 and 25 mg could be included in the therapy, with lower doses being especially important in people who developed renal failure.
The ideal situation with modern drugs would be the one we currently have in Poland with bortezomib. Bortezomib is included in the drug catalog, which means that a doctor can prescribe it to a patient in need without any restrictions. The measure is present in inpatient treatment, which means that the patient can receive it only through the hospital, but in practice it is not a problem.