What is Considered a Line of Therapy?

What is considered a line of therapy?

Yeah, I think the lines of therapy, I think lines are getting blurred even when we define them, pun intended.

But generally speaking,

it used to be that patients would get initial therapy and then they would be off therapy, and then when they would recur, they would get a second line therapy. And that potentially that would be continued usually until a progression. And then they would get next line of therapy when that treatment was no longer working.

That was generally in an era where we didn't have a lot of medications available and certainly we didn't have some of the established ways of treating myeloma patients.

Now, mainly with maintenance therapy that wasn't as defined in the previous year.

So the way we currently think about lines of therapy is really when we're changing their therapy from their initial presentation of disease to the time of relapse. So the first treatment can involve induction therapy with or without a stem cell transplant, usually followed by consolidation and maintenance therapy.

That is basically one line of therapy simply because their disease presented and is now been treated and controlled. And when we're thinking about next line of therapy in that particular scenario, it's basically when the first relapse occurs.

And at that time the therapy is modified. Looking at some of those variables we discussed, such as whether it's a biochemical progression or a more aggressive clinical progression.

But any time a change of therapy has happened in that moment, that's considered second line therapy and then subsequently there forward, any time there's a change in therapy due to progression is where the lines of therapy become a bit more clear on the back end. But generally speaking, in the beginning, we treat the myeloma as we see fit in that particular person and however long that first course lasts and doesn't lead to a relapse is considered one line of therapy.

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