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Multiple Myeloma Discussion • October 31, 2024
Dara-Only Maintenance After Deep Response?
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Diagnosed IGA Kappa smoldering in 2016, active in 2017. Had Rd induction and AST in 2018. MRD negative post transplant. On Revlimid maintenance for five years until relapsed a year ago. Switched to DKd in December 2023. Achieved very deep response - within five weeks, M protein disappeared and Kappa light chains dropped from 500 mg/L to about 6 mg/L (normal range is 3.3 - 19.4) and have stayed at this level since then. I have two myeloma oncologists. One is suggesting we drop the Kyprolis/Dex and just stay on Dara maintenance. Kd does have side effects - no sleep the night of the infusion and possible damage to heart. The other oncologist, who works for a well known myeloma research clinic, is reluctant to do that because no clinical trial has been conducted to determine if PFS would be adversely impacted by dropping the Kd. Question - after achieving a deep response on DKd, or any combination for that matter, has anyone gone on just Dara maintenance and if so, how long have you stayed in remission.
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