How Patients and Clinical Trials Accelerate Myeloma Research

In an interview with Targeted Oncology, George Mulligan, PhD, chief scientific officer of the Multiple Myeloma Research Foundation (MMRF) discusses how he sees the field of myeloma research progressing.

Mulligan believes that the emergence of multiple agents for myeloma treatment is a direct result of the proactive participation of patients and their doctors in clinical trials. While it's understandable that with so many available agents, physicians may choose a straightforward treatment plan, he argues that the lack of a cure necessitates a continued drive to find new ways to delay the disease or achieve a cure.

This is why he emphasizes the crucial role of patients and their doctors in seeking out clinical trial options to complement standard commercial drug use. He encourages the global community of clinical researchers, and their partners in the pharmaceutical industry, to continue offering and exploring these options. Mulligan also stresses the importance of correlative research, which goes hand-in-hand with clinical trials. This includes collecting samples to understand not only the tumor but also the immune system and gathering feedback from patients to understand their experiences in the trials. These elements are critical for optimizing therapy for individual patients and ultimately reaching the point where a specific strategy can be said to cure some patients.

From a translational research perspective, Mulligan finds the prospect of a cure exciting. He says that once a cure is identified, it provides a clear "compass point" for future research. Researchers can then study those patients who are cured and determine what worked best. For example, they might find that the treatment successfully reduced the tumor to a specific size, which then allowed the immune system to recover. This knowledge would then guide the development of new drugs designed to achieve those same 3 critical steps: substantially reducing the tumor, without severely damaging the immune system, and then priming the immune system to control any remaining disease.

Mulligan acknowledges that one of the challenges of having over 10 different agents is the sheer number of possible drug combinations. It is mathematically impossible to test every permutation in a clinical trial due to a lack of available patients. Simply trying different drug combinations in a random or traditional sequence is the least efficient way to make progress. Instead, he advocates for more innovative, research-driven clinical trials. He suggests that these trials should focus on strategies like "knocking down the tumor and bringing back the immune system, but not beating up the immune system for 5 years." He believes that studies with clear goals, such as giving a patient a year of immunotherapy and then monitoring them closely, are what will lead to the best outcomes for myeloma patients.

In closing, Mulligan reiterates that while patients are living longer, most are still dying from their myeloma, underscoring the vital need for continued research and innovation through clinical trials.

This description was generated with assistance from Google Gemini. It was edited and reviewed by Targeted Oncology staff. If you have any questions about the use of AI, please contact us.