What Happens When Multiple Myeloma Returns: Treating Relapses
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/ Updated February 11th, 2022

What Happens When Multiple Myeloma Returns: Treating Relapses

Medically Reviewed: Dr. Doris Hansen Written by: Stephanie Watson
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Treating Multiple Myeloma Relapse

  • Relapse is common after multiple myeloma treatment.
  • Doctors usually treat a relapse with a combination of medications.
  • Which specific drugs you get depend on your past treatments, your health, and other factors.
After the first treatment, many people with multiple myeloma have a long period of remission. It's common to go three years or longer without your symptoms returning. But in time, the cancer can come back or relapse.

"Relapse, unfortunately, is inevitable for patients with myeloma," Dr. Sumit Madan tells SurvivorNet. He's a multiple myeloma specialist at Banner MD Anderson Cancer Center in Arizona. If or when that happens, your doctor will plan the next phase of your treatment.

Treating Relapsed Multiple Myeloma

Read More
Most oncologists treat relapses with a medication. Often that's some combination of a:

  • Proteasome inhibitor like bortezomib (Velcade) or carfilzomib (Kyprolis)
  • Immunomodulatory drug such as lenalidomide (Revlimid) or pomalidomide (Pomalyst)
  • Monoclonal antibody such as daratumumab (Darzalex) or isatuximab (Sarclisa)
Which of these treatments your doctor recommends depends on factors such as:

  • Whether you had a stem cell transplant
  • Which treatments you had before
  • How aggressive your relapse is
  • What other health conditions you have
Most oncologists treat their relapsed patients with a monoclonal antibody such as Darzalex or isatuximab-irfc (Sarclisa), Dr. Madan says. These are anti-CD38 targeted therapies.
Both drugs attach themselves to a protein called CD38 on the surface of multiple myeloma cells. Then they directly attack multiple myeloma and boost your immune system to find and destroy these cells.

RELATED: How to Manage a Multiple Myeloma Relapse

Belantamab mafodotin (Blenrep) is a new type of medication called an antibody drug conjugate. It's an anti-cancer drug attached to an antibody. The antibody hunts down BCMA, which is a protein on the surface of multiple myeloma cells. Then the drug enters these cells and kills them. It also stimulates your immune system to fight your cancer.

How You Get Relapse Medications

You get Darzalex either through an IV into a vein or as a shot just under your skin. The introduction of the shot "has really helped our patients,” Dr. Madan says. “Patients don't need to be sitting in a chair for four to six hours receiving the IV.”

Other drugs such as Velcade also come as an injection under the skin. You get Kyprolis and Blenrep through an IV. And you can take immunomodulatory drugs by mouth.

RELATED: Diagnosing and Treating a First Multiple Myeloma Relapse

Having your cancer return after treatment can be upsetting. Yet today, doctors have more treatments than ever to treat relapsed multiple myeloma. And these new drugs have fewer side effects than older treatments.

"Fortunately, the treatments that we have for multiple myeloma are overall very well tolerated," Dr. Madan says. "When we give a treatment to our patients, we make sure that they will be able to tolerate those drugs."

Learn more about SurvivorNet's rigorous medical review process.

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If you’ve had at least four treatments that have not worked or stopped working you might be a candidate for a treatment called CAR T Therapy.

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CAR-T Therapy for Multiple Myeloma

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