Jane Brody in today’s Times talks of the improvement in survival in multiple myeloma.
She notes there has been marked improvments in survival.
My guarded optimism stems from the progress made in devising treatments for several less well-known malignancies. For many patients with cancers like chronic lymphoma, chronic myelocytic leukemia and now multiple myeloma, longevity lies in the ability of science to remain one step ahead of the malignancy by unraveling its genetic and molecular underpinnings and producing treatments tailored to counter them.
How good is good?
The analyses found a definitive overall increase in the survival of MM patients over the past decade. In particular, five-year survival increased from 28.8 to 34.7 percent, and 10-year survival increased from 11.1 to 17.4 percent. Importantly, survival increased most dramatically in the youngest age group — more than half (56.7 percent) of patients younger than 50 survived at least five years, and more than 40 percent (41.3 percent) survived at least 10 years. In real years, the average relative survival increased from four years after diagnosis in 1990-1992 to almost seven years after diagnosis in 2002-2004.
Patients age 50-59 also fared well, with approximately half (48.2 percent) surviving at least five years, and nearly a third (28.6 percent) surviving at least 10 years. However, only modest increases were seen in the age group 60-69, and virtually no improvement was seen in patients older than 70. Since about half of MM patients are diagnosed when they are 60 or older, the lack of improvement in the eldest groups is a critical finding of the research.
Medicynical note: There are two problems with Brody’s analysis. First as noted in the latter review of progress there has been “modest” improvement for those age 60-69 and no improvement in patients older than 70. FYI the median age of myeloma patients is 66 with just 2%, thankfully, under age 40. Secondly, the cost of new treatments is excessive. The treatments recommended are in the range of $50,000-$100,000/year or more for the drugs alone and multiples of $100,000 for the transplants. This in a disease in which 5 year survival has “improved” to 34%.
Yes, there has been progress but it’s been mainly limited to younger patients and is at tremendous cost. We need to find a way to be more efficient and provide better value.