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Immunotherapy: Which Myeloma Patients Is It Right For?

Immunotherapy: Which Myeloma Patients Is It Right For? from Patient Empowerment Network on Vimeo.

Dr. Krina Patel, a myeloma specialist and researcher, explains how newer therapies, such as CAR T-cell therapy, are being used in myeloma and which patients these treatments are most appropriate for.

Dr. Krina Patel is an Associate Professor in the Department of Lymphoma/Myeloma at The University of Texas MD Anderson Cancer Center in Houston, Texas. Dr. Patel is involved in research and cares for patients with multiple myeloma. Learn more about Dr. Patel, here.

Related Resources:

How Does Immunotherapy Treat Myeloma?

What Are the Side Effects of Myeloma Immunotherapy?

Myeloma Treatment & Research Updates From 2022 ASCO and EHA Meetings

Transcript:

Katherine:   

Now, in reference to immunotherapy and CAR T-cell therapy, who are these types of treatments right for?

Dr. Patel:    

So, I think it’s really exciting that we finally are getting standard of care therapies for all these new immune therapies. So, our first CAR T for myeloma got approved a little over a year ago. Our second CAR T got approved just a couple of months ago, and we’re hoping our first bispecific will be approved in just a couple months.

Our fingers crossed. On the clinical trials, I will say our patients who had a good performance status, meaning they’re able to do everything else normally life-wise, those are the patients that got onto those clinical trials; and the reason is safety-wise.

So, T cells when we use them to kill myeloma, they release cytokines or enzymes, you can say, that are inside the T cells and that’s what they use to communicate with other immune cells to come help them kill.

Those are the same cytokines that make people feel really ill when they have the flu, for instance. So, as our immune system tries to fight infections when people get fevers, they feel chills, they feel just fatigued and tired, it’s those same kind of cytokines that, even when you try to kill the myeloma with T cells, people can get that same type of symptoms.

And really, the main, fevers and things like that, we can take care of. But when patients’ blood pressure drops or if their oxygen levels drop really low, that’s where we can run into some trouble. Now, the good news is, in myeloma, most of these new therapies don’t cause really bad CRS [Cytokine Release Syndrome] or really bad neurotoxicity that we can sometimes see. And so, thankfully most patients are okay, but really it’s making sure that none of our patients have bad toxicity. So, most of our myeloma patients, I will say, are eligible for these therapies. However, if someone has really bad heart disease or really bad lung disease, those are patients that maybe these are not the right therapies for.

Understanding Your Role in Myeloma Treatment Decisions

Understanding Your Role in Myeloma Treatment Decisions from Patient Empowerment Network on Vimeo.

Many factors are considered when choosing a myeloma treatment. Dr. Nina Shah, a myeloma expert, reviews how treatment decisions are made and the patient’s role in deciding on an approach.

Dr. Nina Shah is Associate Professor of Medicine in the Department of Medicine at the University of California San Francisco (UCSF) and treats patients at the Hematology and Blood and Marrow Transplant Clinic at UCSF Helen Diller Family Comprehensive Cancer Center. Learn more about Dr. Shah, here.

See More From Engage Myeloma


Related Programs:

What Key Steps Should Follow a Myeloma Diagnosis

What Key Steps Should Follow a Myeloma Diagnosis? 

What Key Questions Should Myeloma Patients Ask About Treatment

What Key Questions Should Myeloma Patients Ask About Treatment? 

An Expert Reflects on Hopeful Advances in Myeloma Treatment

An Expert Reflects on Hopeful Advances in Myeloma Treatment 


Transcript:

Katherine Banwell:

What are the main factors that you take into consideration before a treatment approach is decided on?

Dr. Shah:

We always have to remember that treating a patient is also treating a person. So, it’s not just about what the disease the patient has but who the patient is. And so, we take into consideration goals that the patient as well as other health factors that may take – be taken into consideration. For example, the patient may have high blood pressure or a heart condition. But regarding the disease, we really also take into consideration what the profile of the disease is, maybe how much disease burden the patient has and some genetic factors that may impact our decision-making.

Katherine Banwell:

What is the patient’s role in treatment decisions?

Dr. Shah:

The patient should always be the center of the decision-making. I think that’s a really important thing for us to remember because ultimately, it’s the patient who has to make the decision and has to withstand the treatment. Alongside of that there may be some caregivers as well, but the patient has to, 1.) understand the disease, and 2.) understand the treatment options. So, it’s best if the patient has as much information as possible.

Katherine Banwell:

Are treatment considerations different for patients with relapsed disease?

Dr. Shah:

For patients with relapsed disease, there’s a lot of things to consider that may not have been true when the patient was first diagnosed. For example, you always have to think of what maybe the patient had as a prior – excuse me, as a prior treatment, and also how the patient tolerated it. 

Expert Tips for Managing MPN-Related Anxiety

Expert Tips for Managing MPN-Related Anxiety from Patient Empowerment Network on Vimeo

Health-related anxiety and worry can be overwhelming. Dr. Jennifer Huberty provides advice for using complementary approaches to cope with the emotional impact of a chronic cancer, like myeloproliferative neoplasms (MPNs).

Dr. Jennifer Huberty is an Associate Professor at Arizona State University. She focuses her research on the use of complementary approaches to manage symptoms and improve quality of life for patients living with myeloproliferative neoplasms. More about Dr. Huberty here: chs.asu.edu/jennifer-huberty.

See More From the The Path to MPN Empowerment

Related Programs:

Can Diet and Exercise Reduce MPN Symptoms?

Am I Meditating Correctly? Getting the Most Out of Mindfulness

Improving Life with MPNs: The Latest Research and How to Get Involved


Transcript:

Dr. Jennifer Huberty: 

With anxiety and worry – it’s like we get in this state of mind that we can’t seem to get out of, and then, thoughts just keep piling in and piling in and adding to more anxiousness and more anxiousness, and so, the key is quieting the mind, and the best way to do that is to focus on your breath, and again, just coming back to the moment, coming back to the moment. You can do body scans where you’re just thinking about where your body is in space, going from the tips of your toes all the way to the top of your head.

I recommend guided meditation for MPN patients, especially because it is difficult. The anxiety and worry is real. The fears are real. This is a – it’s a traumatic event to be diagnosed with any cancer, and the brain is a powerful thing in terms of getting in our way of healing and feeling better, and so, knowing that it’s powerful, we can quiet our mind so that our body can learn to let go. And, I will say that spending that time doing that with the anxiety and worry, there will be physiological symptoms that change – so, heart rate goes down, blood pressure goes down, sweaty palms decrease, stomachaches – those kinds of things will tend to go away as anxiety and worry goes down.

And, the other important thing I would say is a tip for managing is to be self-compassionate. So, that’s a big part of meditation and yoga philosophy, is self-compassion. And so….being okay with being anxious and being okay with being worried, and there’s nothing wrong with that, and it’s completely normal.

And so, learning to be compassionate in ways that you would be compassionate to a sibling, or a parent, or a best friend – use those same compassionate thoughts and feelings toward yourself.

Notable News: October 2018

How tall are you? Do you eat breakfast cereal? What’s your blood pressure? Oh, and, moms, how old were you when you had babies? The answers to these questions just might be an indicator of your cancer risk. Sounds strange, doesn’t it? Well, if October’s Notable News teaches us anything, it’s that strange is not so unusual, especially when it comes to cancer risks.

The mysterious workings of the human body continue to offer up surprises, and appropriately enough for October, the latest surprise is about breast cancer, according to medicalexpress.com. For some time, scientists have known that women who have babies before the age of 30 have a reduced risk of getting breast cancer later in life, but now they know the specific week in which the risk reduction occurs. Women who have babies after 34 weeks averaged a 13.6 percent lower risk of developing breast cancer than did women who had no children. The risk reduction if the pregnancy ended just one week earlier was only 2.4 percent. Researchers don’t yet know what magic happens in the 34th week, but they do know that women must be under the age of 30 to benefit from it. More information can be found here.

While we’re on the subject of breast cancer, let’s talk about men because they get breast cancer, too. As Patient Empowerment Network blogger and breast cancer survivor Marie Ennis-O’Connor noted in her October 19 post, Beyond Pink: The Other Side of Breast Cancer Awareness and Lessons We’ve Learned From Each Other, breast cancer is not gender specific. While men make up less than one percent of all breast cancer occurrences, says breastcancer.org, an estimated 2,550 men in the United States have been or will be diagnosed this year. And because men are not routinely screened for breast cancer, they tend to be diagnosed when the disease is more advanced; therefore, it’s important for men to know the risk factors, which can be found here. While breast cancer awareness still focuses mainly on women, more attention is beginning to shift toward men, even making it’s way to primetime television. The series premiere of the new ABC drama A Million Little Things introduces a main male character who is a breast cancer survivor. More information about symptoms, diagnosis, and treatment of breast cancer in men can be found here. Please, take the time to find out if you, or the men you love, have any of the risk factors.

There’s a new risk factor to be mindful of…your height. That’s right. Your height. As reported by the guardian.com, the taller people among us are more likely to get cancer simply because they have more cells in their bodies. More cells means more opportunity for mutation. Apparently, it’s true for dogs, too. Bigger dogs, bigger risks. In humans, height seemed to cause an increased risk for 18 out of 23 cancers, including melanoma, which had a stronger link to height than researchers expected. Since there’s not much you can do about your height, researchers suggest that you focus on other risk factors instead, by maintaining a healthy weight and not smoking. Learn more about how height affects your cancer risk here.

You might want to consider breakfast cereal, too, reports freep.com. There is a chemical called glyphosate, the active ingredient in the weed killer, Roundup, that is showing up in products that are made with “conventionally grown” oats, which includes a lot of breakfast cereals. The International Agency for Research on Cancer says glyphosate is probably carcinogenic for humans, but Monsanto, the maker of Roundup, maintains the product is safe. While some experts say the information isn’t cause for hysteria, it is a good idea to pay attention to where your food comes from and what might be affecting it. You can find more about the glyphosate content in foods and which foods are affected here. It’s best to stay informed about the potential risks and use your best judgement.

The same holds true for those of you taking blood pressure medication. medicalexpress.com reports that some blood pressure medications might be linked to an increased lung cancer risk. The drugs are angiotensin converting enzyme inhibitor drugs (ACEIs), and the risk is elevated for people using the medication for five years or more. Overall, the risk is low, but is notable because of how widely ACEIs are prescribed. ACEIs are very effective at treating blood pressure and, if patients have concerns about any potential cancer risks, they should consider the risks and benefits with their doctors. There is still a lot more to be learned about ACEIs and their connection to lung cancer. You can find out more here.

Whether you’re a tall person who eats breakfast and has high blood pressure or you have some other strange cancer risk, the main thing to remember when it comes to risk factors is to stay informed, because when you have knowledge, you are empowered and that’s what it’s all about.