alen in DexTech's complementary venture.
Multiple myeloma is a form of cancer that occurs in the bone marrow, where a type of white blood cell called plasma cells develops into cancer cells. The cancer cells interact with bone-destroying osteoclasts, which cause pain and fractures. The disease leads to a lack of normal blood cells and thus a weakened immune system and anemia. A person affected by myeloma becomes easily short of breath and tired and gets infections more easily due to the weakened immune system.
Great medical need
Multiple myeloma is less common than other blood-related cancers such as leukemia and lymphoma. Each year, approximately 170 000 people around the world and it is estimated that the disease causes around 120 deaths annually. Thanks to new treatments, survival rates have increased in recent years, but there is still a great need for new treatments to continue to improve treatment outcomes. Today, the 000-year survival rate is just over 5 percent.
The global market for the treatment of multiple myeloma was estimated in 2018 at approximately 19,5 billion USD and is expected to grow at an annual growth rate of around 6 percent to reach a size of over USD 30 billion by 2026.
Immunomodulatory treatments dominate
Although new drugs in recent years have changed the treatment options, chemotherapy is still used in multiple myeloma, not least high-dose therapy supported by stem cells. However, the combination is only suitable for patients who are still in good shape, as it is very taxing on the body.
However, current treatment for multiple myeloma consists in the majority of cases of various combinations of immunomodulatory drugs, proteasome inhibitors and monoclonal antibodies. How the drugs are combined depends on several different factors, such as the stage of the disease, age, kidney function and general condition. In general, it can be said that the drug combinations aim to strengthen the immune system's ability to fight cancer, while at the same time trying to prevent cancer cells from dividing and growing strong.
Today, the most common component of a combination therapy for myeloma is Celgenes blockbuster Revlimid, an immunomodulatory drug introduced in 2017 that had sales of $12,8 billion last year. Other commonly used drugs include Bristol Myers Squibbs monoclonal antibody Empliciti and Velcade, a proteasome inhibitor co-developed by Japanese Takeda Pharmaceuticals and Belgian Janssen Pharmaceutical.
Upcoming treatments in the same vein
Although much has happened regarding the treatment of multiple myeloma in recent years, survival rates remain low and there is a great medical need. Even the treatments that are currently being tested in clinical trials are generally different combinations of already existing drugs, both combinations that have not been tried before, but also combinations targeted at different subgroups within the patient population.
A player who has a different approach is Uppsalabolaget. DexTech, which is currently preparing a smaller clinical proof-of-concept study to evaluate the drug candidate OsteoDex relevance for the treatment of the disease. OsteoDex has a mechanism of action where bone resorption is slowed while the tumor cells are killed. OsteoDex is specifically enriched in the diseased area of the skeleton through the bisphosphonate contained in OsteoDex.
Clear effect in prostate cancer
DexTech has previously shown clear treatment efficacy in a phase IIb study in metastatic castration-resistant prostate cancer (mCRPC). In preclinical studies, the company has also identified potential in multiple myeloma, a disease condition that has much in common with bone metastases from prostate cancer (interaction between bone cells and tumor cells). Preclinical studies have shown that OsteoDex is highly effective against myeloma cells and has a more potent cell-killing effect than against prostate cancer cells.
However, nothing is certain until efficacy in humans has been demonstrated, which is what the upcoming study is intended for. If DexTech can verify OsteoDex's proof of concept against multiple myeloma, the company's portfolio would therefore include a drug candidate with potential in two different cancer indications with large market values.