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.
Click the orange button to the right to learn more about what you can start doing today.
- You are here:
- Home »
- Blog »
- Multiple Myeloma »
- Discontinue Induction Therapy in Myeloma?
Discontinue Induction Therapy in Myeloma?
Have you ever wondered if myeloma patients discontinue induction therapy completely because of their side effects, aka adverse events, when undergoing induction therapy?
You’ve been diagnosed with a blood cancer called multiple myeloma. Your oncologist strongly suggests that you begin your induction therapy immediately. You’ve heard the saying that “the cure is worse than the disease.”
But what does this mean for MM patients undergoing chemo for the first time?
Starting Myeloma Treatment: What to Know About Induction Therapy and Its Goals
What percentage of newly diagnosed myeloma patients change their induction therapy because of adverse events aka side effects?
Studies indicate that a significant percentage of newly diagnosed multiple myeloma (MM) patients discontinue induction therapy early due to adverse events (AEs), although the exact percentage can vary depending on the study and treatment regimen
Key Findings from Research:
- ECOG-ACRIN E1A11 Trial: In a study involving patients treated with bortezomib (VRd) or carfilzomib (KRd) plus lenalidomide and dexamethasone, 13.4% of patients discontinued treatment early due to AEs.
- Dara-VRd vs. VRd (Perseus Trial): In the Perseus trial, serious AEs leading to treatment discontinuation were reported to be higher in the Dara-VRd group compared to the VRd group (57% vs 49.9%).
- Dara-VRd vs. VRd (Griffin Trial): Conversely, in the Griffin trial, treatment discontinuation due to TEAEs occurred in fewer patients in the Dara-VRd group compared to the VRd alone group (15.2% vs 20.6%).
- Isatuximab-VRd vs. VRd:The incidence of adverse events leading to definitive discontinuation was 22.8% with isatuximab-VRd and 26.0% with VRd.
Factors Associated with Treatment Discontinuation due to Adverse Events:
- Higher Adverse Effect Bother: Patient-reported high levels of adverse effect bother have been associated with increased odds of early treatment discontinuation.
- Worsening Side Effects: A worsening of patient-reported side effect bother by 2 or more categories was linked to a higher likelihood of early discontinuation.
Important Considerations:
- Different studies may report varying rates of adverse events and treatment discontinuation due to differences in study design, treatment regimens, patient characteristics, and how side effects are reported.
- The use of “minimizing terms” when describing adverse events in clinical trials may not always reflect the true rates of AEs.
- Simple patient-reported assessments of adverse effect bother can be helpful in identifying patients at risk of early treatment discontinuation.
In summary, while the overall percentages can vary, studies indicate that a notable proportion of newly diagnosed MM patients experience adverse events that lead to the discontinuation of their induction therapy.
I am a long-term MM survivor. Long-term side effects caused by my chemo and radiation have dramatically affected my quality of life. As a result of this, I offer studies and information that may help other MM patients deal with conventional MM therapies.
MM patients considering stopping their induction therapy completely should consider ways to treat their MM while suffering fewer side effects from treatment.
Email me at David.PeopleBeatingCancer@gmail.com to learn more about managing your MM with both conventional and non-conventional therapies.
Hang in there,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Patient-Reported Adverse Events and Early Treatment Discontinuation Among Patients With Multiple Myeloma
Abstract
Importance There is substantial interest in capturing cancer treatment tolerability from the patient’s perspective using patient-reported outcomes (PROs)…
Exposures GP5 response options were “very much,” “quite a bit,” “somewhat,” “a little bit,” and “not at all.” Responses at each assessment while undergoing treatment (1 month, 2.8 months, and 5.5 months) were categorized as high adverse event bother (ie, “very much,” and “quite a bit”) and low adverse event bother (ie, “somewhat,” “a little bit,” or “not at all”). In addition, change from baseline to each assessment while undergoing treatment was calculated and categorized as worsening by 1 response category and 2 or more response categories.
Main Outcome and Measure ETD due to adverse events (yes vs no) was analyzed using logistic regression adjusting for treatment group, performance status, gender, race, and disease stage.
Results Of the 1087 participants in the original trial, 1058 (mean [SD] age 64 [9] years; 531 receiving VrD [50.2%]; 527 receiving KRd [49.8%]) responded to item GP5 and were included in the secondary analysis. A small proportion (142 patients [13.4%]) discontinued treatment early due to AEs. For those with high adverse-effect bother, GP5 while undergoing treatment was associated with ETD at 1 month (adjusted odds ratio [aOR], 2.20; 95% CI, 1.25-3.89), 2.8 months (aOR, 3.41; 95% CI, 2.01-5.80), and 5.5 months (aOR, 4.66; 95% CI, 1.69-12.83). Worsening by 2 or more response categories on the GP5 was associated with ETD at 2.8 months (aOR, 3.02; 95% CI, 1.64-5.54) and 5.5 months (aOR, 5.49; 95% CI, 1.45-20.76).
Conclusions and Relevance In this survey study of the E1A11 trial, worse GP5 response was associated with ETD. These findings suggest that simple assessment of adverse-effect bother while receiving treatment is an efficient way to indicate treatment tolerability and ETD risk.
Conclusions
In conclusion, in this survey study, we report the GP5 item’s ability to capture treatment tolerability among a sample of patients with multiple myeloma. Our results indicate that patients who report high AE bother on the GP5 had higher odds of discontinuing treatment early.
This study suggests that GP5 may be a useful, succinct way to track whether cancer patients tolerate their treatment and may identify patients vulnerable to tolerability-associated early discontinuation.
discontinue induction therapy discontinue induction therapy