What is MM?
A recurring, multi-stage cancer with a long, demanding treatment journey
ELUSIVE & DIFFICULT-TO-DIAGNOSE. MM (Multiple Myeloma) is a slowly escalating hematological cancer primarily occurring in the bone marrow. It chiefly affects older adults, more commonly men, with a mean age of diagnosis of 69 years.
MM is notoriously difficult to detect. Many can have it for months or years before diagnosis, without even knowing they are sick. In fact, only 5% are diagnosed in the early stages (giving them a 71% 5-year survival rate), with the vast majority receiving a later-stage diagnosis and a 50% 5-year survival rate with chemotherapy. First-line chemotherapies are effective, but can cause severe, challenging side effects that can be more disabling than the disease symptoms for some patients, making it difficult for them to adhere to their treatment regimes.
- 140,000 (approx.) people in the US currently have MM (1)NIH, SEER, Multiple Myeloma
- 25,000 (approx.) new cases occur annually in the US (roughly 7.5 per 100,000)
- 30,000 (approx.) new cases occur annually in France, Germany, Italy, Spain and UK (2)Datamonitor Healthcare, MM Epidemiology 2018
- 81,050 is the number of new cases forecast to occur in the US, Japan, France, Germany Spain, Italy and the UK by 2037, an increase of 39.3% (3)Global Data Multiple Myeloma Forecasts, 2019
DYNAMIC TREATMENT LANDSCAPE. MM follows a relapsing pattern, where patients go through several lines of treatment – with periods of remission followed by relapses as the cancer cells become resistant to the treatment. Because of this, newly approved drugs for MM appear relatively regularly. Survival rates have been extended in recent years, through new treatments and existing ones – including the ImiD’ class of immunomodulatory drugs, with its core first-line chemotherapy Lenalidomide (commercial name Revlimid).
LENALIDOMIDE: CORE CHEMOTHERAPY
WITH POOR COMPLIANCE.
Lenalidomide is an oral thalidomide analog with multiple effects on tumor cells and the tumor microenvironment. Patients take Lenalidomide daily as an oral tablet (25mg) for 21 days continuously in a 28-day cycle. Whilst Lenalidomide is undoubtedly effective (4)Multiple Myeloma Research Foundation (Revlimid clinical studies have shown improved survival in patients with newly diagnosed/untreated MM and in patients following stem cell transplants) side effects can be severe – and for some more disruptive and uncomfortable than their MM symptoms.
Diarrhea, fatigue and nausea are commonly reported, but more severe side effects can include Deep Vein Thrombosis (10% of MM patients who take Lenalidomide immediately after diagnosis) and pulmonary embolism (4% of MM patients taking Lenalidomide after other MM treatments that were not effective) (5)Medical News Today Long-term use can also lead to higher risk of new and / or secondary malignancies (6)Revlimid – https://www.revlimid.com/serious-side-effects.