Did you happen to read the comment from Terry yesterday following my post slamming skeletal surveys? Just in case you missed it…
I started the carfilzomib trial at the NIH this weekend for newly diagnosed patients. While I was diagnosed as a smolderer, I was given a concurrent PET/MRI there. They have the only machine in the US. The others are in Germany where they were invented–Siemens, Munich. Dr. Landgren feels these advanced imagining modalitites are the wave of the future, not the cheap so-called “Gold Standard” radiographic skeletal survey which does not really visualize bone marrow activity in a bone marrow cancer. In my case, my skeletal survey was normal….but the PET/MRI noted abnormal uptake in the marrow, etc. With my dropping hemoglobin, it was time to treat. I am so lucky they offered me a slot in the carfilzomib trial. My doctor believes the treatment may have the potential to create deep and long lasting responses for years without a SCT. I think I’ll bag my stem cells anyway in case but I like his philosophy that SCT’s in the era of carfilzomib, etc. are not obligatory.
Just think. Maybe additions of carfilzomib and pomalidomide will give doctors enough ammunition to help replace auto stem cell transplants as the standard of care for myeloma patients younger than age 70 or 75. Exciting!
Because I’m sorry–calling auto SCTs “tolerable” is at best a stretch. Skipping them altogether would definitely be a step in the right direction.
Of course, myeloma docs will still need some additional weapons in order to dump SCTs altogether. But those seem to be on the way. Remember yesterday’s post about Reolysin? Or as the manufacturing company, Oncolytics Biotech Inc. of Canada prefers, REOLYSIN.
Here is some info about the use of this cutting edge respiratory enteric orphan virus from the company’s website:
REOLSYIN® has been developed from the naturally-occurring reovirus. Reovirus (Respiratory Enteric Orphan Virus) is a common virus that most people (70% to 100%) have been exposed to in their lifetime. The virus is considered asymptomatic, meaning that there are no particular symptoms associated with it. Unlike other viruses that continue to reside in the body after infection, the body will eliminate reovirus within two weeks. Because it is considered such a “safe” virus, it has been used for decades by research institutions and individuals studying viral replication structure. In 1998, graduate students (including myself) working in a laboratory at the University of Calgary discovered that this particular virus seemed to be able to replicate itself in cancer cells that have what is called an activated Ras pathway, one of the most common family of genetic defects leading to cancer. Up to two-thirds of all human cancers, including many brain cancers, are Ras-activated, and are therefore a target for reovirus therapy.
Here’s how it works: Viruses on their own cannot replicate. They need to borrow a host cell’s manufacturing equipment. A virus particle will enter a cell, borrow the manufacturing equipment, and replicate itself within the cell until the cell dies, or the body’s natural defenses kill the virus particles. If the virus is successful in killing the cell, the progeny virus are then free to infect and kill surrounding cells.
When the reovirus enters a normal cell and attempts to borrow the cell’s manufacturing equipment to replicate itself, an anti-viral protein called PKR is able to quickly neutralize the virus. In a Ras-activated cancer cell, however, this anti-viral response is turned off. The reovirus is able to replicate itself within the cancer cell, resulting in that cancer cell’s death. The cycle of infection, replication and cell death will be repeated until there are no longer any cancer cells available.
I believe that Reolsyin is administered by IV. It has actually been around for at least a decade . But researchers keep tinkering with it, and seem very optimistic about how well it will work against multiple myeloma.
Like always, I will keep you updated on this site and MyelomaNews.com.
I was going to share the news about my visit with my myeloma specialist, Dr. Alsina last week. I will get to that tomorrow.
No tease–the news was sort of no news at all. Let’s just say I’m sentenced to a life of perpetual post SCT chemo. I’m OK with it. Really! Details to follow.
Feel good and keep smiling! Pat
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