We are inundated with snippets of news from a host of clinical studies reporting interesting (and even exciting) results for us, myeloma patients. The caveat with all those snippets is that they tend to come from early study results (preclinical or Phase I – dose ranging/safety studies) or from Phase II studies with limited numbers of patients and short-term follow-up outcomes. At times, it is good to step back and be aware of the long-term outcomes from the current, FDA approved products in the MM treatment armamentarium.
A recent issue of the Journal of Clinical Oncology reports long-term follow-up data of the largest group (1,000 consecutive newly diagnosed MM patients) treated with the combination Revlimid-Velcade-dexamethasone (also known as RVd). Most of us MM patients will be familiar with this three-drug regimen. The study included both transplant-eligible and non-transplant-eligible patients. Let’s look at the make-up statistics of this patient pool:
The results are impressive!
The authors of the journal article draw two key conclusions :
And there you have it : the regimen that most of us are familiar with is a good way to start and continue. Some of us, however, will relapse and some of us will become refractory to any of the drugs used in this combo. That’s when other drugs will enter into the mix and we have options available, not only with different immunomodulators (such as Pomalyst instead of Revlimid), different proteasome inhibitors (such as Kyprolis) and also the addition of biologicals (such as Darzalex).
In 2014, I was told by my specialist, “We have a good program for starters and what we will try and do is buy time. There are exciting developments in the near-term horizon that will give us good options and alternatives in the future.” And she absolutely right. I have an opinion about the cost of RVd but, I will also be the first to admit that this regimen has bought me almost 6 ½ years of high-quality life. Ergo, I don’t complain much about RVd (in my own opinion, of course).
about the author
I am a patient diagnosed in 2014 with primary plasma cell leukemia (pPCL), a rare and aggressive variant of multiple myeloma and have been very fortunate to find successful treatment at the division of Cellular Therapy at the Duke University Cancer Institute. My wife, Vicki, and I have two adult children and two grandsons who are the ‘lights of our lives’. Successful treatment has allowed Vicki and I to do what we love best : traveling the world, albeit it with some extra precautions to keep infections away. My career in the pharmaceutical industry has given me insights that I am currently putting to use as an advocate to lower drug pricing, especially prices for anti-cancer drugs. I am a firm believer that staying mentally active, physically fit, compliant to our treatment regimen and taking an active interest in our disease are keys to successful treatment outcomes.