Recently Diagnosed or Relapsed? Stop Looking For a Miracle Cure, and Use Evidence-Based Therapies To Enhance Your Treatment and Prolong Your Remission
Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.
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Deep Response to RD for Myeloma
What if NDMM patients could predict a deep response to RD (revlimid/lenalidomide dexamethasone) for myeloma? What if newly diagnosed myeloma patients could take a genetic test for their response to induction therapy?
Consider less chemo, less toxicity, fewer side effects with a long progression-free survival, possibly longer overall survival?
Before you get too excited about this finding I need to explain that the study linked below is complicated indicating that the findings appear to be far from daily practice in your oncologist’s office.
Having said that, I should quickly follow on to say that in all of my research of multiple myeloma since the year 2000, I have never read a study documenting NDMM patients doing BETTER with LESS chemotherapy.
Oncology and drug companies continually find reasons for NDMM patients to take more chemo, not less. Yes, NDMM patients are living longer than ever but I believe these patients are only doing so by taking more and more chemo damaging their health, feeling lousy, while costing increasing amounts of money.
Taking this study a step further-
What if oncology identified other NDMM patients who were “deep responders” to other types of chemotherapy?
- Bortezomib/velcade
- Darzelex/daratumumab
If it’s one thing I’ve learned since my myeloma diagnosis in ’94, it’s that oncologists follow success with modest tweaks leading to more but slightly altered success.
Using this finding to manage your myeloma-
When writing about multiple myeloma, I often cite an essay titled Treatment of Myeloma: Cure vs. Control by Dr. Vincent Rajkumar. Dr. Rajkumar simply offers a low-dose, less toxic approach to managing myeloma. I think that “deep responders” are ideal candidates for the control approach to managing myeloma.
What is Revlimid/lenalidomide?
In my view, the study linked below is more about a way of thinking about a deep response to RD as a myeloma therapy than an actual FDA approved therapy plan. The essay about cure vs. control explains this possible therapy plan. Both illustrate a less is more, low-dose approach to managing multiple myeloma.
If you would like to learn more about myeloma- either conventional or non-conventional therapies email me at David.PeopleBeatingCancer@gmail.com
Thank you,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Deep hematologic response to RD treatment in patients with multiple myeloma is associated with overexpression of IL-17R in CD138+ plasma cells
“However, less is known about predictors of good response to LEN-based treatment. The aim of this study was to identify molecular pathways associated with good and long response to LEN.
The study included newly diagnosed MM patients (NDMM) and MM patients treated with first-line LEN and dexamethasone (RD) who achieved and least very good partial remission (VGPR).
RNA was isolated from MM cells and new-generation sequencing was performed. Obtained results were validated with qRT-PCR.
A global increase in gene expression was found in the RD group compared to NDMM, suggesting the involvement of epigenetic mechanisms.
Moreover, upregulation of genes controlling the interaction within MM niche was detected. Next, genes controlling immune response were upregulated. In particular, the gene encoding the IL-17 receptor was overexpressed in the RD group which is a novel finding…
However, we analyzed samples obtained from patients with a long-lasting and deep response to LEN, with no signs of a relapse. To the best of our knowledge, this is the first observation and probably a novel finding reporting upregulation of genes and processes associated with interaction with the tumor niche during LEN treatment.
LEN not only interacts with MM cells, but also affects various cells in the bone marrow, affecting MM niche38,39. We demonstrated that despite deep and long-lasting response, genetic profile suggests that tumor niche remains, at least partially, permissive to MM…
Treatment of Myeloma: Cure vs Control
“Although not often openly acknowledged, “cure vs control” is the dominant philosophical difference behind many of the strategies, trials, and debates related to the management of myeloma. Should we treat patients with myeloma with multidrug, multitransplant combinations with the goal of potentially curing a subset of patients, recognizing that the risk of adverse events and effect on quality of life will be substantial? Or should we address myeloma as a chronic incurable condition with the goal of disease control, using the least toxic regimens, emphasizing a balance between efficacy and quality of life, and reserving more aggressive therapy for later?”