The Spokane medical community is emerging as a national leader in a new treatment for multiple myeloma, a serious form of blood cancer, says Dr. Hakan Kaya, an oncologist, hematologist, and senior partner at Spokane-based Cancer Care Northwest.

An alternative to chemotherapy, referred to as bispecific antibody therapy, the treatment involves harnessing a patient's own immune system to combat the cancer. Kaya says many patients have had successful outcomes using that therapy. 

“In our experience, almost everybody we treated achieved a complete remission shortly after starting the treatment,” he says. “After the first few doses, most patients have almost no side effects from the treatment.”

Due to the complexity of the treatment, most myeloma patients around the U.S. have been traveling to major medical centers in big cities. It's unusual to be able to attain such treatments in a mid-size market without a major academic health system, with the Spokane market being an exception, he says. 

“Myeloma patients in Spokane are able to receive this therapy here at home,” says Kaya, adding that Cancer Care Northwest also treats patients from throughout Eastern Washington, Idaho, and western Montana. “We are one of the largest community bispecific centers in the country.”

Conventional treatment for multiple myeloma involves chemotherapy, a treatment that uses chemicals to kill fast-growing cells in the body. 

"Chemotherapy," he adds, "is not selective in the cells it targets, which also affects healthy, rapidly dividing cells, including cells that line the gastrointestinal tract, leading to nausea and vomiting."  

Elrexfio, a bispecific antibody developed by pharmaceutical company Pfizer, uses a patient's own immune system to fight cancer cells.The drug kills targeted cells using the body’s own T cells, which are normally used to fight off infections. 

"Targeted therapies recognize certain markers on myeloma cells and kill them directly without damaging the normal cells," Kaya says.

The drug, which is injected under the skin like a flu shot, has two “arms,” he says.

“Bispecific antibodies … have one arm that grabs a cancer cell and one arm that grabs a person’s T cell and puts them together,” Kaya explains. “When a T cell gets closer to a cancer cell, it kills it.” 

The drug was approved by the Food and Drug Administration in 2023.

The injections are administered weekly, at first, and then switched to a monthly dosage. The first two doses require hospitalization for a a period of two nights, Kaya says. 

He says the therapy isn’t without risks, which is the reason not all private practices, or community centers, provide the therapy. One of the most serious side effects, cytokine release syndrome, can cause life-threatening complications like low blood pressure, shortness of breath, and heart problems, he adds.

Cancer Care Northwest partners with Providence Sacred Heart Medical Center for the treatment.

“We’ve trained the nurses on the oncology floor of SHMC, which has been very supportive of the program,” Kaya says. “We admitted our first patient … in summer of 2023, only a few months after approval of myeloma bispecifics. Since then, we’ve treated 75 patients, which is a record in the country for a community center.” 

Providing the treatment locally, as opposed to patients having to travel for treatment, is life-changing, Kaya says.

"They will either get the therapy here or lose their lives," he says. "This is life and death for a lot of patients."

Multiple myeloma, a chronic, currently incurable disease, is the second most common form of blood cancer, Kaya says. Lymphoma, cancer of the white blood cells, is the most common. Untreated myeloma patients die from this form of cancer in a matter of months to a few years, he says. 

“It is estimated that in the United States more than 36,000 new cases will be diagnosed in 2025 alone,” he says. “There are currently approximately 180,000 people living with multiple myeloma in the United States.” 

Multiple myeloma primarily affects older adults, with a median age at diagnosis of 69 to 70 years, Kaya says. However, the disease can strike younger individuals as well.

"One-third of U.S. myeloma patients are younger than 65," he says. "In our center, our youngest myeloma patient was 26 years old. We've had several patients in their 30s and many in their 40s and 50s, but most were older."

Bispecific antibodies have also been approved to treat patients with acute leukemias, lymphomas, and  lung cancer, Kaya says. 

Cancer Care Northwest is a physician-owned oncology practice that has operated in Spokane for 50 years. It is comprised of 22 physicians, specializing in medical, surgical, and radiation oncology, and has nine advanced practice providers, along with nearly 300 support staff.

Currently, Cancer Care Northwest operates six clinics throughout Eastern Washington and northern Idaho.

The practice offers comprehensive cancer care encompassing physician services, surgery, chemotherapy, diagnostic imaging, radiation, and access to other support, including registered dietitians and social services.

Kaya is a fellowship-trained transplant physician who specializes in multiple myeloma and B-cell lymphomas. He is the founding director of the Inland Northwest Myeloma/Lymphoma and Transplant Program, established in 2005. Kaya is a clinical professor with Washington State’s Elson S. Floyd College of Medicine and a clinical professor of medicine at University of Washington School of Medicine.