We are international
Donate

In evaluating the new innovations that have contributed to better survival and quality of life for myeloma patients, it is helpful to ask: Where did these new innovations come from? By way of illustration, several items have been selected and are summarized in the accompanying Table.

It is very clear that the origin of myeloma management advances derives from pharmaceutical and related corporations. However, the impetus to these corporations has frequently stemmed from academic research, but at a basic level of chemistry, physics, molecular and cellular biology, and the like. Fundamental research involves organisms as diverse as yeast, worms, flies, and mice, which share many essential molecular mechanisms with humans. The lowly fruit fly (Drosophila Melanogaster), whose genome has now been fully sequenced, has perhaps revealed the most about genes and disease.

The application to myeloma has come from clinical investigators ? frequently keen young investigators looking for new ideas, who have introduced new diagnostics or therapies as part of clinical trials. The critical observations have been assessments of benefit in terms of better diagnosis, more frequent response to treatment, and/or longer or better quality of survival.

We do not yet have a cure for myeloma. But combination therapy can be curative for several cancers, including testicular cancer (see Myeloma Today Volume 3, Number 6), childhood acute leukemia, and lymphomas. Clinicians came up with the curative therapy through ?investigator initiated? trials. It is likely that the cure for myeloma will emerge from similar ?bedside research? involving physicians not working in a laboratory.

"Bench to Bedside" is therefore not exactly a myth, but the bench work usually substantially precedes the bedside research and is typically in a different city or country from the subsequent pivotal clinical observations.

Identifying promising strategies and expediting appropriate clinical trials are therefore the rate-limiting steps. The IMF is committed in its research program to support and accelerate clinical research development of the several new approaches currently under development.

INNOVATION EXAMPLE
ORIGIN
Corporations or other entities
APPLICATION
IN MYELOMA
Clinical Trials
Diagnostics
?Serum b2
microglobulin test

?MRI

Pharmacia (Scandinavia)
Single inventor/developer: subsequently sold to corporations
Clinical Trials in the US, UK, France, Australia
Clinical trials in US and Germany
Supportive Care

?Recombinant
erythropoietin (EPO)

?Biophosphonates

Johnson/Johnson; Ortho Biotec; AMGEN
Several Corporations (e.g., Chiron, Novartis)
First clinical trial in Austria
Pivotal trials in Finland, UK and US (multinational)
Myeloma Treatment
?Alpha Interferon
?Standard Chemotherapy

-Melphalan

-Adriamycin

Schering-Plough and Roche


Burroughs Welcome

Adria Laboratories
Early trials with Finnish Red Cross; pivotal trial in Italy with recombinant product

Trials in UK, US and Canada

Cooperative group studies plus VAD US trial