“Trending treatments” doesn’t sound very scientific. Sounds a bit more like fads in music or social media. But there are definite trends in how we treat our maladies. We learn, grow and change as our knowledge grows. As with all changes we make, we let go of some concepts in order to grasp new ones. This letting go can be challenging because we have experiences with drugs and procedures that work, and we have confidence in those treatments.

As a patient, I’ve noticed this desire to hang on to treatments. For example, the drug Venetoclax has been so effective for me. I tend to think everyone with the t(11;14) translocation ought to have Venetoclax. Other patients who have had tremendous success with being treated with autologous stem cell transplants can’t imagine living without them. It’s wonderful that these treatments work so well.

Yet, their very success can make them difficult to let go of. I noticed the scientists at ASH 2021 recognize that this past year we have had quite a bit of “Out with the Old” and “In with the New” taking place. They, like us patients, seem to have some favorite treatment options that have been highly effective, and are in a sense having to let go of them. Ouch!

Here are some of the old concepts that used to be helpful that are now OUT According to Dr. Nina Shah, University of California, San Francisco.

OUT during 2021

1. Categorizing patients as transplant eligible or not transplant eligible. Out!
2. Revlimid/ Velcade/ Dexamethasone for everyone as the first treatment for multiple myeloma. Out!
3. Facebook. Out!
4. Texting. Out!

IN for 2021

1. Minimal Residual Disease negativity has become a goal for treatments. In!
2. Tailored therapy that is specific for the patient. In!
3. Three drug treatments = Triplet regimens. In!
4. Four drug treatments = Quadruplet regimens as the first line of treatment. In!
5. Snapchat. In!
6. Tik Tok. In!

This may mean the average multiple myeloma patient can expect to learn about some new treatments, names of new meds and new tests.  Here are a few quotes I heard while attending the session "A glimpse into the future of Myeloma Patient Management" presented by Dr. Nina Shah and Dr. Amrita Krishnan at ASH 2021.

“Kyprolis is the new Velcade.”

Moving forward  Kyprolis will be used more frequently with Revlimid and Dexamethasone as a first treatment.

“Quads are here to stay.”

This seems to indicate that instead of the 3 drug treatments typically used up front, newly diagnosed patients will be receiving 4 meds as their first line of treatment.

“Isatuximab is the new Daratumimab.”

It sounds like we will be seeing “Isa” in the place of “Dara” soon in combination with Kyprolis, Revlimid and Dex.

“Kyprolis joined with Revlimid looks like it has a bright future as a ‘maintenance regimen.’”   

Dr. Amrita Krishnan of The City of Hope Medical Center indicated:

“Treatments evolve, we might not be using these treatments.”

As myeloma patients, we typically undergo tremendous changes in our bodies, quality of life, and finances when we are diagnosed with cancer. Now we — patients, doctors and researchers —may benefit by the many new and powerful changes in treatments.

This is exciting news, though a bit overwhelming, knowing that more effective treatments are in the pipeline that will not only keep myeloma at bay, but also may improve our quality of life.

Steve volunteers his time as a Myeloma Coach to help others navigate the many changes in their life associated with a diagnosis of myeloma.  Visit the Myeloma Coach website to  connect with a Coach and find help managing these changes in your own life. 

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