UConn Health first in US to give promising drug to treat multiple myeloma. It ‘gave me back my life.’

A promising new treatment for multiple myeloma, recently approved by the Food and Drug Administration, has been offered at UConn Health, the first in the United States.

Dr. Swarup Kumar, who leads UConn Health’s myeloma treatment team, has treated seven patients with the new therapy so far, and five have had positive results, he said.

“It was approved by the FDA in October of last year,” Kumar said. “So we jumped on the process to get the drug here pretty quickly, and we got our first patient pretty much as soon as the FDA approved the drug.”

Soledad Cruz of East Hartford was the second patient to be given the drug, Kumar said, and she said she’s feeling much better.

“He gave me back my life,” she said of Kumar.

Her daughter, Jessica Torres, agrees.

“With this new treatment, she’s been able to do things at home: cleaning, cooking, walking, driving better,” she said. “Her concentration is a lot better. Mood swings are better. So it is a 360 from the previous chemotherapy with this new treatment.”

The road hasn’t been easy, though.

“After she gets the infusion, the body will get in such a pain, like a bone pain, body aches, muscle deterioration,” Torres said. “She couldn’t get up and walk normal because everything hurt. So that was one of the side effects.”

Cruz also was fatigued by the cocktail of drugs she was on, which included steroids to reduce inflammation. But she’s much better now, she said.

Multiple myeloma is an incurable cancer of the blood, in which plasma cells in the bone marrow become malignant, decreasing the ability to make healthy cells and producing harmful proteins that cause pain in the bones and other symptoms.

“Patients often have anemia, which results in fatigue or shortness of breath,” Kumar said. “A patient can end up in kidney failure, where they might even end up eventually needing dialysis or other types of treatments.

“You have several treatment options for myeloma that are promising,” he said. “However, this new drug that came out recently appears extremely promising, even for patients that have crossed several lines of treatment already and have not had a response.”

The new drug, teclistamab (marketed as Tecvayli by Janssen Biotech) was given accelerated approval by the FDA. It works as a kind of immunotherapy by harnessing immune cells in the body to attack the myeloma cells, Kumar said.

“It’s a dual-binding drug,” he said. “Once inside our body it binds to both the T lymphocytes, the immune cells, and on the other side it binds to the cancer cell, the myeloma cell.”

This triggers more immune cells to release enzymes and proteins that kill off the cancer cells. “Meaning the drug itself doesn’t necessarily kill cancer, but it works by harnessing our own immune cells to go and fight the cancer,” Kumar said.

There are drugs similar to teclistamab that treat leukemia and other diseases, Kumar said, but this is the first for multiple myeloma. There are four other drugs being tested that act like teclistamab but target other parts of the cancer cell.

“Essentially, all these drugs bind to the T cell and then work by choosing a different target on the cancer cell and then affecting the response,” he said.

Cruz, who is now in remission, had been through four different treatments without success. “She was about to go for a vacation to Peru because she thought, it’s not doing well,” Kumar said. “She knows what it’s looking like for her, having exhausted all these treatment options. And she was suffering from a lot of infections.”

He and his staff persuaded her to stay and undergo the new treatment. The first three doses must be given in the hospital because of potential side effects. “And then, remarkably, she did pretty well with the treatment and her numbers came back pretty close to zero,” Kumar said. “So the levels that we saw in the blood related to the cancer are now pretty much undetectable.”

The side effects are related to the immune response, which can become overactivated.

“We have a fever that often manifests and we have some drugs to kind of calm down the immune system in case it gets overactivated too much,” Kumar said. “So that’s the reason why we hospitalized and monitored because this can happen in patients. But once the body is trained to be accustomed to the drug, then it’s pretty much smooth sailing.”

Of the seven patients has treated, five responded well and two did not. “But, of the five patients that had a response, three of them have had a really superb, outstanding response,” Kumar said.

Now, patients must undergo four other treatments before they can be given teclistamab. Kumar wants to start clinical trials to see how well the drug works if given sooner, before the immune system is too weak.

“It’s all about giving folks the quality of life as well as having the best response we can get,” Kumar said. “So far, all drugs in myeloma that are approved, especially end-stage or later, they all work very poorly. They don’t have a good response. And they also cause a lot of side effects.

“Here we have a treatment that can cause side effects that’s very well manageable, but at the same time it has the potential to cause a deep response,” he said.

“I wish this medication would have come a while ago,” Torres said. Cruz has been “battling multiple myeloma five years, going every week for infusion sessions,” she said.

Now that she is in remission, Cruz said that trip to Peru is looking more promising.

Ed Stannard can be reached at estannard@courant.com.