Multiple myeloma is a life-threatening form of blood cancer that starts in the plasma cells of the blood. Myeloma cells accumulate in the bone marrow and slowly degenerate the kidneys and bones of the body. Also called plasma cell myeloma, it is not completely curable. Multiple myeloma is very challenging to treat and is the second most common cancer in the US.

Diagnosis occurs when abnormal plasma cells are detected in the bone marrow, and treatment is worked out around controlling organ damage.

• Chemotherapy
• Stem cell transplantation
• Radiation
• Medications

Immunotherapy helps in cancer treatment for multiple myeloma patients by focusing on three approaches:

• Reversing tumor mediated immune paralysis: This is done using immunomodulatory drugs and by blocking inhibitory molecules or activating stimulatory molecules.
• By stimulating myeloma specific immune responses: This is done using vaccines that work by stimulating an immune response against tumor specific antigen or substances that the body considers foreign.
• Selectively eliminating the malignant clones: This is done by removing T-cells from the body, thereby genetically engineering and reintroducing them into the body. T-cells start multiplying and then locate and destroy the tumor cells.

The U.S. Food and Drug Department recently approved two drugs for relapsed multiple myeloma treatment . One of the drugs is approved for patients who have already been treated with three therapies. It is a first in class immunotherapy treatment (a monoconal antibody) which works when the patient has become resistant to other treatments or when the disease spreads in a very short span of time. The other drug prods the immune system to attack cancer cells. It is for patients who have undergone one to three therapies earlier.

Cancer treatment has potential side effects:

• Infusion related reaction
• Tiredness and difficulty in breathing
• Back pain
• Fever and nausea
• Persistent cough
• Low count of red blood cells, white blood cells, and platelets

Immunotherapy and precision medicine as cancer treatment options work for multiple myeloma patients. A better understanding of causes behind relapse and undertaking new therapies to overcome that resistance is the key to immunotherapy cancer treatment.