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Patient Power: Taking a Drug Holiday for Multiple Myeloma Patients

Posted: Jul 06, 2018
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Many multiple myeloma patients are on some form of maintenance therapy that typically includes a chemo-type drug (like Revlimid). Some are on a one or two-year maintenance plan; others are opting for continual maintenance. For those of us who have taken these drugs, we live with those side-effects: chemo brain, fatigue, neuropathy, gastrointestinal problems, and much more. So this often begs the question: Can I take a drug holiday from maintenance therapy and is it wise? Tempting. Because we generally feel far better when we're not taking certain medications.

On Patient Power,  Dr. Robert Orlowski from MD Anderson Cancer Center, answers this question. He then answers the question of what to do when a patient starts showing signs of progression. 

Here is a summary of what Dr. Orlowski says on taking a maintenance holiday:

[I] try to continue to give [Revlimid] every day unless patients have side effects, in which case, of course, taking a break or reducing the dose is important.  But we do need studies to answer this question, because it may be that drug holidays would be fine. But until we know that for sure, I’d rather keep hitting the myeloma when it's done and therefore try to avoid drug holidays or breaks if people are doing well with maintenance.

And what he says about testing when there are signs of progression:

Any time there is evidence that the myeloma is progressing I think about repeating a bone marrow and doing the cytogenetics and the FISH testing all over again, because we do sometimes see that new abnormalities emerge which can have an influence or treatment decisions or abnormalities that were present before at a low level all of a sudden become the predominant form of the myeloma.

For the full transcript, visit the Patient Power site here.

Many multiple myeloma patients are on some form of maintenance therapy that typically includes a chemo-type drug (like Revlimid). Some are on a one or two-year maintenance plan; others are opting for continual maintenance. For those of us who have taken these drugs, we live with those side-effects: chemo brain, fatigue, neuropathy, gastrointestinal problems, and much more. So this often begs the question: Can I take a drug holiday from maintenance therapy and is it wise? Tempting. Because we generally feel far better when we're not taking certain medications.

On Patient Power,  Dr. Robert Orlowski from MD Anderson Cancer Center, answers this question. He then answers the question of what to do when a patient starts showing signs of progression. 

Here is a summary of what Dr. Orlowski says on taking a maintenance holiday:

[I] try to continue to give [Revlimid] every day unless patients have side effects, in which case, of course, taking a break or reducing the dose is important.  But we do need studies to answer this question, because it may be that drug holidays would be fine. But until we know that for sure, I’d rather keep hitting the myeloma when it's done and therefore try to avoid drug holidays or breaks if people are doing well with maintenance.

And what he says about testing when there are signs of progression:

Any time there is evidence that the myeloma is progressing I think about repeating a bone marrow and doing the cytogenetics and the FISH testing all over again, because we do sometimes see that new abnormalities emerge which can have an influence or treatment decisions or abnormalities that were present before at a low level all of a sudden become the predominant form of the myeloma.

For the full transcript, visit the Patient Power site here.

The author Allyse Shumway

about the author
Allyse Shumway

MyelomaCrowd Editorial Contributor. Daughter to a parent with cancer.

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