Dr. Noopur Raje, MD
Massachusetts Cancer Center and Raje Lab
Interview date: January 17, 2014
Myeloma cells can't survive outside of the bone marrow. Dr. Noopur Raje, MD, of Massachusetts General Cancer Center tells us that the "soil" in which they are growing is an important target for new treatments. Dr. Raje describes her work to make the bone marrow neighborhood as unfriendly as possible to stop the growth of myeloma cells. She describes how current myeloma drugs can change the bone marrow environment: Proteasome inhibitors boost new bone growth while the IMiDs boost immunity and bump up natural killer cells. She then expands the capacity of those drugs using a new HDAC inhibitor called ACY-1215 with existing myeloma drugs. In one study, Velcade blocks the protein pathway while the HDAC inhibitor blocks another pathway and prevents the cells from becoming Velcade-resistant. She uses another example of combining this same new drug with IMiDs to affect a commonly mutated gene called C-Myc. She describes a trial for older patients using a standard triple combination that can be modified for age by lowering the dosage (RVD Lite). She regularly performs genetic testing as part of her standard care and is looking to target specific genes, using the BRAF and MEK genes as examples. Her research suggests that treating the bone marrow environment can also help to heal bone lesions. Dr. Raje reminds us that the 9 new myeloma drugs in the last 10 years came about because patients participated in myeloma trials. She notes that when patients wait to join a clinical trial when they are out of options, it is not really helpful, and encourages patients to take advantage of early access to therapies that go beyond the standard of care.
The live mPatient Myeloma Radio podcast with Dr. Noopur Raje
Noopur Raje, MD, is director of the Center for Multiple Myeloma at Massachusetts General Hospital. She is also Associate Professor of Medicine at Harvard Medical School. Her primary focus is treating patients with multiple myeloma and related plasma cell disorders. Dr. Raje leads a dedicated clinical team engaged in investigator-initiated, multi-center national and international clinical trials, all aimed at developing new promising therapies for multiple myeloma. Her laboratory efforts are focused on identifying cellular signaling pathways that contribute to the survival and proliferation of myeloma cells in the bone environment for which targeting may result in improved therapeutic outcomes.
Myeloma survivor, patient advocate, wife, mom of 6. Believer that patients can help accelerate a cure by weighing in and participating in clinical research. Founder of the HealthTree Foundation.
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