Is a Clinical Trial Right for Me?

You can also find a clinical trial yourself:

• Search by disease and location at government websites including clinicaltrials.gov and cancer.gov.
• Other organizations that let you search for clinical trials on their websites include The Center for Information and Study on Clinical Research Participation (ciscrp.org) and CenterWatch.com.
• Check the websites of hospitals, medical schools, or cancer centers in your area. They may list trials they’re doing or tell you how to get in touch with their research departments.

The Leukemia and Lymphoma Society has a service that gives you guidance on finding and taking part in a clinical trial at lls.org.

New and Emerging Treatments

To get past drug resistance, scientists are developing new drugs in the same categories as those already approved to treat multiple myeloma. They’re also testing new combinations of three and even four of these drugs. And they’re looking at different kinds of drugs that attack multiple myeloma in new ways. Here are some of the most promising areas of research.

Targeted therapy: Chemotherapy kills fast-growing cells. That includes cancer but also many normal cells. Targeted therapy looks for weaknesses unique to cancer cells that can be taken advantage of to kill them without harming healthy cells. Drugs under development include:

• Proteasome inhibitors. These allow molecular “garbage” to build up inside multiple myeloma cells until they die. You’ve probably had at least one of these drugs. Bortezomib, carfilzomib, and ixazomib are approved to treat RRMM. But it can become resistant to them. Researchers are trying these drugs in different combinations and testing new ones.
• Antibody-drug conjugate. This is a new kind of treatment using an antibody that attaches itself to a tumor cell and delivers a drug that kills it. The drug belantamab mafodotin-blmf was recently approved for people with RRMM who’ve tried at least four other treatments. It finds a receptor called a B cell maturation antigen (BCMA) that’s plentiful in myeloma cells and almost nowhere else. Other similar drugs are being tested.
• BCL2 and MCL1 inhibitors. BLC2 and LCL1 are proteins that allow damaged myeloma cells to repair themselves. Drugs are being tested that block the action of these proteins, either alone or in combination with approved treatments.

Immunotherapy: This type of treatment harnesses your body’s own disease-fighting system to identify and attack cancer cells. A number of new therapies are being explored:

• Immunomodulators. Most of the drug combinations for treating RRMM include a drug that helps your immune system fight the cancer, either lenalidomide or pomalidomide. New kinds of immunomodulators are being tested for people who stop responding to these.
• T-cell therapy. Two recently approved treatments for RRMM use what are called chimeric antigen receptor (CAR) T cells. These are your own immune cells that have been removed, modified to better recognize and attack myeloma cells, then put back into your blood. The new treatments look for the BCMA protein. More of those are in the pipeline, along with others that use different receptor targets. 
• Bispecific T-cell engagers (BiTE). This kind of drug contains an antibody that attaches to both a receptor on a multiple myeloma cell and a protein on an immune cell. That causes the immune cell to attack the cancer cell. Several BiTEs are being tested.
• Checkpoint inhibitors. Checkpoints tell your immune system when to fight and when to back off. Cancer cells can trick these checkpoints into applying the brakes and letting them live. Checkpoint inhibitors put your immune system back to work fighting your cancer. Researchers are developing a number of these drugs. 

What to Expect From a Clinical Trial

Once you and your doctor have found a promising experimental treatment, find out everything you can about how the study is being done and what researchers hope to learn. Whoever is sponsoring the trial – often a drug company – may have information on their website. Or you can contact them directly.

In general, here’s what you can expect from a clinical trial:

• You’ll have an interview with someone at the study to make sure you qualify. You may need to be a certain age or have a certain stage of cancer. Some trials want people who’ve already tried certain treatments.
• Before you enroll, you’ll get detailed information about the study, including the risks and possible benefits of the new treatment, and any rules you’re expected to follow. The people running the study want to make sure you understand exactly what you’re signing up for. 
• Find out what costs there may be for tests and treatments. Usually, these are covered either by your health insurance or the study itself. You might even get paid by the study for expenses like travel.
• After you enroll, you’ll give details about your medical history. You may have a physical exam and blood work or imaging tests.
• During the study, you’ll get whatever treatment is being tested, or you may be in a control group to see whether the new treatment is better than the standard treatment. You’ll also have checkups and tests to see how well the treatment is working and how you’re doing.
• Taking part in a clinical trial is voluntary, and you’re free to quit at any time, for any reason.

If you don’t qualify for a clinical trial, you may still be able to get the newest treatments for relapsed/refractory multiple myeloma. Expanded access or compassionate use programs sometimes offer unapproved medications to people who are very sick and have no other options. Check with your doctor.