How is a line of therapy defined?

How is a line of therapy defined?

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

To make this part easier to understand, here's a graph showing the progression of myeloma over time. When the line goes up, myeloma is growing or the patient is relapsing. When the line goes down, the myeloma is responding to lines of treatment.

But generally speaking, you know, 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 then potentially that would be continued usually until progression. And then they would get the 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 and usually followed by consolidation and maintenance therapy. That is basically one line of therapy, simply because the disease presented and is now being 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 discuss, 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.

Anytime 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.

To keep track of your lines of therapy, go to HealthTree and track your disease on the treatments and outcomes page.