There are no treatments that can cure WM, although in most cases the disease is indolent (slow growing) and can be effectively managed with appropriate therapies.
Imbruvica (ibrutinib) was approved by the US Food and Drug Administration on January 29, 2015, as the first drug specifically designated for the treatment of WM. It has since been approved by Health Canada and the European Medicines Agency for use in the European Union. Prior to that time, most of the treatments in use had already been approved for the related cancers of follicular lymphoma, chronic lymphocytic leukemia, and multiple myeloma. Once Phase 1 and Phase 2 clinical trials established that these treatments had an acceptable safety profile and were effective for WM patients, they were prescribed for “off label” use in WM.
While Ibruvica, an oral drug that targets the Bruton’s tyrosine kinase (BTK) pathway in B-cell growth and development, is a very important step forward in treatment, it is not a cure for WM and not everyone responds to it. Many of the older, established treatments are still appropriate for WM patients, and there are several new treatments still in the research pipeline that may achieve FDA approval as well.
When treatment is being considered, a WM patient may want to ask his or her local hematologist-oncologist to consult with a WM expert at a major medical center for a second opinion about the necessity for treatment and the various treatment options available. This can be very helpful because few hematologist-oncologists in private practice have a great deal of experience with a rare disease like WM. For an overview of treatment options, both in the front-line and relapsed settings, watch the approximately 60-minute video presented at the 2018 IWMF Educational Forum by Dr. Shuo Ma of Northwestern University in Chicago. A patient may also want to investigate the option of participating in a clinical trial.
Just as the symptoms of WM are different in each patient, responses to treatment vary greatly. What works well for one patient may not work so well or even not at all for another. Researchers are exploring these differences in treatment responses with the idea that they may be largely due to variations in each person’s disease biology and unique genetic makeup. New therapies targeted to these variations are being developed, with the ultimate goal of tailoring or personalizing treatment for each patient.
This section of the website explores the reasons for undergoing treatment, the philosophy of watch and wait, current treatment options, common side effects of treatment, types of treatment responses, treatment following relapse, and treatment guidelines from several of the WM experts. It also presents information regarding instances where transformation and myelodysplasia could occur, and available complementary and integrative medicine options.