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Berenson Myeloma QoL OS
Berenson Myeloma QoL OS- According to the articles linked and excerpted below, Dr. James Berenson, Myeloma specialist, reports the longest average overall survival of MM patients while striving for the highest possible quality of life for those patients.
Is this possible? The longest OS and the highest quality of life? Let’s dig into the specifics…
FDA approved standard-of-care for all newly diagnosed MM patients is a good one-size-fits-all approach to newly diagnosed MM patients. I am a long-term MM survivor who has witnessed MM patients achieving longer both PFS and OS since my diagnosis with MM in early 1994.
Though the SOC might not be the best possible treatment plan for, say, the stage 1 MM patient or the young MM patient with no CRAB symptoms. Berenson seems to not believe in a one-size-fits-all approach. And he certainly doesn’t believe in the benefit of an ASCT for MM patients.
The FDA approved SOC for all newly diagnosed MM patients is
- VRdD induction therapy followed by
- An ASCT followed by
- Low-dose maintenance revlimid/lenalidomide
A lower-dose approach is, by definition, less toxicity and less toxicity equates to fewer side effects.
So what does Dr. Berenson study mean for newly diagnosed multiple myeloma (NDMM) patients?
- First and foremost, it is important to understand that NDMM patients have a choice in how their MM specialist practices MM treatment. Berenson approach, good or bad, is different than other conventional MM specialists.
- Secondly, according to Berenson’s study, his low-dose approach yields longer average overall survival and a higher average quality of life.
- Thirdly, Berenson’s approach does seem to yield superior results for high-risk MM patients.
- Fourthly, Berenson’s approach is more expensive and may require more time on the patient’s part. Berenson is one man in one clinic in California. If you don’t live in CA, you will need to find an oncologist who will work with him.
- Lastly, I think it’s important for the average NDMM patient to understand that the FDA’s job is to authorize a care plan that is reproducible in every hospital in every state across the United States.
Have you been diagnosed with multiple myeloma? Do you have questions about your treatment plan? Let me know-
David.PeopleBeatingCancer@gmail.com
Hang in there,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Survival on the Upswing in Multiple Myeloma
“In a new study, Dr. Berenson tracked 161 patients with MM treated at his West Hollywood, Calif., private clinic from 2006 to 2023 and found that their median survival was 136.2 months – more than 11 years. “The OS reported in this study … is the longest reported to date in an unselected, newly diagnosed MM population,” the study authors write…
According to Yale Medicine,
- MM accounts for 10% of blood cancers and
- 1%-2% of all cancers
- and is more common in men vs. women and Blacks vs. Whites.
- It’s most frequently diagnosed between the ages of 65 and 74,
- according to the National Cancer Institute, and the median age at diagnosis is 69…
Dr. Berenson’s new study, published in Targeted Oncology, tracked 161 patients (89 women, 72 men; median age, 65.4; 125 White, 3 Black, 10 Hispanic, 15 Asian, and 8 multi-ethnic).
All started frontline treatment at Dr. Berenson’s clinic and were included if they could read consent forms and gave permission for blood draws. None underwent stem-cell transplants as part of initial therapy. Another 1,036 patients had been treated elsewhere and were not included in the study.
Over a median of 42.7 months (range, 1.9-195.1), the 1-, 3-, and 5-year survival rates were
- 97.5%,
- 85.3%,
- and 76.2%,
respectively.
The study claims “these results are considerably better than those reported from patients enrolled in clinical trials and those from countries with national registries…”
In the interview, Dr. Berenson said the study is unique because it’s not limited like many studies to younger, healthier patients. Nor does it include those treated at other facilities, he said.
The study is unusual in other ways. Dr. Berenson said his drug regimens aren’t necessarily standard, and he doesn’t treat patients with stem-cell transplants. “I stopped transplanting in about 2000 because clearly it was not improving the length of life,” he said…
Dr. Berenson said colleagues can learn from his insistence on
- sensitively treating the quality of life of patients,
- his embrace of clinical trials with novel combinations,
- and his close monitoring of myeloma proteins to gauge whether patients need to rapidly switch therapies…
He (Berenson) noted that his drug regimens are typically off-label and vary by patient. “We’re not using as high doses of drugs like Velcade [bortezomib] or Revlimid [lenalidomide] as my colleagues. We’re not necessarily giving as many doses. Also, we’re not adding as many drugs in many cases as they are. We’re taking it slower.”
The National Comprehensive Cancer Network recommends bortezomib and lenalidomide as standard induction treatments in patients with MM who are candidates for stem-cell transplantation, a procedure it considers the “preferred approach in transplant-eligible patients.”
There are limitations to Dr. Berenson’s new study. The patients aren’t representative of people with MM as a whole: His cohort is overwhelmingly White (78%) and just 2% Black, while an estimated one-fifth of patients with MM in the United States are Black and have poorer outcomes.
Dr. Berenson also acknowledged that his patients are most likely a wealthier group, although he said it’s not feasible to ask them about income. The study provides no information about socioeconomics…
Dr. Fonseca discloses relationships with AbbVie, Adaptive Biotechnologies, Amgen, AstraZeneca, Bayer, Binding Site, BMS (Celgene), Millennium Takeda, Janssen, Juno, Kite, Merck, Pfizer, Pharmacyclics, Regeneron, Sanofi, Adaptive Biotechnologies, Caris Life Sciences, Oncotracker, Antegene, and AZBio, and a patent in MM. Dr. Berenson discloses ties with Janssen, Amgen, Sanofi, BMS, Karyopharm, and Incyte. Dr. Lonial reports ties with TG Therapeutics, Celgene, BMS, Janssen, Novartis, GlaxoSmithKline, AbbVie, Takeda, Merck, Sanofi, Pfizer, Regeneron, and Novartis.”
Clinical Outcomes and Serum B-Cell Maturation Antigen Levels in a Real-World Unselected Population of Newly Diagnosed Multiple Myeloma Patients
“Patients and Methods-
None of these patients underwent an autologous stem cell transplantation as part of their initial therapy and the population had a high proportion (35%) of cytogenetic high-risk patients…
Results
With a median follow-up of 42.7 months, the cohort had a median PFS of 22.8 months and a median OS of 136.2 months. The 1-, 3-, and 5-year survival rates were 97.5%, 85.3%, and 76.2%, respectively. These results are considerably better than those reported from patients enrolled in clinical trials and those from countries with national registries…”