AN IRISH PERSON with a type of blood cancer called ‘multiple myeloma’ has become the first in the world to take part in a new drug trial for patients with the disease who respond poorly to standard chemotherapy treatment.
Symptoms of multiple myeloma include high levels of fatigue, because of low numbers of red blood cells; kidney damage is quite likely because of high number of antibodies filtering through the organ; and a high risk of infection, because of a low count of white blood cells.
There are 1,500 cases of blood cancer in Ireland, with about 250 new cases every year. Although this isn’t a high figure in comparison to breast cancer, for example, which has over 2,800 new diagnoses a year, the rate of death is much higher.
Over 10% of those with multiple myeloma die from the disease, and because there is no treatment currently available other than chemotherapy, it’s common that a life expectancy of three to five years given once diagnosed.
The trial is hoping to offer a new type of treatment by weakening the binding agent that allows cancerous cells to stick to protein in the blood, making chemotherapy less effective. The treatment has already had some level of success in trials of leukemia – in which the first person to take part in the trial was also Irish.
What’s involved in the trial
Leading this new study is Professor Michael O’Dwyer, CEO of the Blood Cancer Network. He told TheJournal.ie that the patient won’t suffer any extra side effects than “if they were on chemo alone”.
The trial involves a short infusion treatment the same day as their standard drug treatment on the drug bortezomib, which is the main drug used to treat multiple myeloma, he explains.
“This can be done up to twice a week, for two weeks, with one week off; or once a week.”
The trial can last for as long as the patient benefits from the treatment, and must last for a minimum of eight months to be classed as a viable study – although testing of the results could take another 10 months.
This is not a trial is not for patients who are developing a lot of side effects. It’s for patients who are already performing relatively well – but not as well as we’d like.
“Those who are diagnosed with multiple myeloma are usually in their 60s and 70s. In clinical trials with younger patients, we’re able to give them more ‘aggressive’ treatments.”
But in this case, because the patients are quite elderly, treatment options are more limited.
Professor O’Dwyer says the patient is given the usual counselling services available to those going through treatment, and says they will receive “more attention” – including spending more time with their nurse – because they are taking part in a clinical trial.
In relation to whether there are any major issues with those who take part in clinical trials, Professor O’Dwyer says that the biggest issue is raising awareness of the trial.
“It’s really difficult to get the word out there, but once we do, patients seem reasonably happy.”
This current trial needs a further 20-30 people before the treatment can be ruled as safe.
Funding the research
Professor O’Dwyer says that “we are on the cusp of revolutionary treatment for myeloma” with a new trial for the drug daratumumab to begin later this year - but also says there are “facing major challenges” in funding these “exciting” new treatments.
There are major reimbursement delays in Ireland – for example when a drug gets approved it can take a couple of years to get those before it reaches the market.In an era with loads of medical challenges, clinical trials provide a realistic way of reducing our expenditure on drugs, but it’s something that really needs to be embraced by the HSE, the Department of Health, and universities.With a bit of joined up thinking, Ireland could play a really big role in this area, but it does require ongoing support across the system.
Funding for the pre-clinical research was funded by the Health Research Board.
In February of this year, the Irish Cancer Society will invest an additional €450,000 over the next five years to support the expansion of the Blood Cancer Network in Ireland.
Consultant haematologist at Beaumont Hospital, Dr John Quinn, said at the time:
“The Irish Cancer Society is proud to be partnering with Science Foundation Ireland on the funding of Blood Cancer Network Ireland, ensuring that Irish blood cancer patients benefit from the latest advances in cancer care and treatment.”
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