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.
Let’s suppose that you have just been diagnosed with multiple myeloma (MM). You either don’t want to have or can’t have an autologous stem cell transplant (ASCT). Your oncologist conveys the findings of the first study linked and excerpted below. In short, DRd (darzelex, revlimid, dex.) provides, on average, a longer “PFS” than the current standard-of-care induction therapy RVd aka revlimid, velcade, dexamethasone.
The average newly diagnosed MM patient would say great, I’ll do the darzelex with R and d please!
And that decision is fine. As long as you understand all relevant information. Relevant to you that is.
The reality of modern day MM treatment is
As the saying goes, MM is a marathon, not a sprint.
The challenge to you then, is to think through, as much as possible, a treatment plan that accounts for all available conventional and non-conventional therapies. By conventional, I mean chemotherapy regimens such as Daratumumab as well as Bortezomib (Velcade). It is not one or the other but both- over a period of years.
Consider the idea that “less is more” as the saying goes. Chemotherapy is toxic. Toxicity damages you-short, long-term and late stage. A long PFS is important. But toxicity, how you feel during that PFS, is just as important.
Just as importantly, consider what the second study below is saying. If the NDMM patient undergoes Bortezomib/velcade as induction therapy, MM patients can use it again or “rechallenge” your MM with it again.
Evidence-based, non-conventional therapies, in my experience anyway, must be part of the NDMM therapy plan.
NDMM patients must balance the damage done my their MM and the damage done by chemotherapy.
If you’d like to learn more about managing your MM for the long-term, scroll down the page, post a question or a comment and I will reply to you ASAP.
“Daratumumab (Darzelex) in combination with lenalidomide-dexamethasone (D-Rd) recently received FDA approval for the treatment of transplant-ineligible patients with newly diagnosed multiple myeloma (NDMM).
The present PEGASUS study compared progression-free survival (PFS) in patients treated with D-Rd in the MAIA trial and patients treated with common standard-of-care regimens from the Flatiron Health electronic health record-derived deidentified database, which has data from patients treated primarily at community-based oncology practices in the United States.
Individual-level patient data from both data sources were used to perform an anchored indirect treatment comparison (ITC) of Darzelex-Rd to bortezomib-lenalidomide-dexamethasone (VRd) and bortezomib-dexamethasone (Vd); lenalidomide-dexamethasone (Rd) was the common anchor for the ITC…
After application of MAIA inclusion/exclusion criteria and propensity-score weighting, the Flatiron Health patients resembled the MAIA trial population on measured baseline characteristics.
Based on the direct comparison within MAIA, treatment with D-Rd was associated with a significantly lower risk of progression or death compared to Rd. Based on the ITCs, D-Rd was associated with a significantly lower risk of progression or death compared to VRd and Vd.
In the absence of head-to-head trials comparing Darzelex-Rd to VRd or Vd, the present ITC may help inform treatment selection in transplant-ineligible patients with NDMM.
BD ‐ Consultancy: Amgen, Celgene, Johnson & Johnson, and Takeda. SK ‐ Takeda: Research Funding: Takeda, Janssen, Celgene; Consultancy: Janssen, Celgene. SU ‐ Speakers bureau: Amgen, Celgene, Janssen, Sanofi, Takeda; Research Funding: Amgen Array Biopharma, Bristol‐Myers Squibb, Celgene, Janssen, Merck, Pharmacyclics, Sanofi, Takeda; Consultancy: Amgen, Bristol‐Myers Squibb, Celgene, Janssen, Merck, SkylineDx, Takeda. EA, AL, and RK ‐ Employment and equity: Janssen. EM was employed by Janssen when the study was conducted. TF ‐ Advisory committee: Celgene, Janssen, Takeda, Amgen, Sanofi; Speakers bureau: Celgene, Janssen, Takeda.
“Therapeutic re-challenge is currently a debated issue in the field of multiple myeloma (MM), given the recent availability of several new drugs and combinations.
However, very few specific evidences are available about bortezomib re-use at first relapse. This multicenter, observational, retrospective study enrolled 134 MM patients with significant response after bortezomib-based frontline regimens and who had received a first salvage treatment containing bortezomib at relapse.
The overall response rate was 71%, including
Re-treatment was well-tolerated, with no significant new or unexpected toxicities observed.
The median duration of second progression-free survival (PFS) was 15 months, while median PFS2 was 55 months. With a median follow-up of 56 months, overall survival was 94 months for the entire series, without significant differences between patients undergoing or not undergoing transplant procedures.
This real-life survey indicates that re-treatment including bortezomib as a first salvage therapy could be still considered in MM patients achieving durable response after initial exposure to bortezomib.”