What I wish I knew about Multiple Myeloma treatments 25 years later...

Download the FREE ebook "Beating Myeloma: If I Knew Then What I Know Now" and arm yourself with the information about autologous stem cell transplantation, treatment options, and side effects that I wish I had known about when I began treatment.

Frailty Index Predicts Myeloma Outcome

Share Button

The use of this ECOG PS–containing frailty scale as a predictive measure of clinical outcomes in patients with transplant-ineligible Newly Diagnosed Multiple Myeloma

My guess is that if you’re reading this blog post, you don’t need a study (linked below) to tell you that frail newly diagnosed multiple myeloma patients (NDMM) don’t respond as well to toxic therapy as non-frail NDMM patients do and that frail NDMM don’t live as long as non-frail NDMM do.

FDA approved multiple myeloma chemotherapy and radiation therapies are toxic. Therefore the frail patient’s health is damaged the instant he/she ingests it.

To put this in real terms, my induction therapy and autologous stem cell transplant saddled me with a host of short, long-term and late stage side effects. I haven’t been the same since. I was 35 at the time.

The issue is what can the frail NDMM do about it? Many things. There are a host of evidence-based but NON-toxic therapies shown to be cytotoxic to MM. Anti-MM nutrition, complementary therapies, lifestyle therapies and more.

The FDA and pharmaceutical companies will never test curumin on MM. This is a nutraceutical and can’t be patented.

Keep in mind that half of all newly diagnosed MM patients (33,000 annually in the U.S.) are over 70. This is the average age of the NDMM patient. That’s about 16,500 people annually. Also keep in mind that clinical trials usually include people 65 and younger.

I don’t know how many of this group would qualify as “frail” but I’ll bet it’s a lot. As a long-term MM who prides himself as not undergoing toxic therapies since his complete remission in early 1999, I think frail MMers should focus on evidence-based, non-toxic therapies.

Are you a frail newly diagnosed MM patient? Are you caregiving a frail NDMM patient? Scroll down the page, post a question or comment and I will reply to you ASAP.

Hang in there,

 

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:


A simplified frailty scale predicts outcomes in transplant-ineligible patients with newly diagnosed multiple myeloma treated in the FIRST (MM-020) trial

“Patients with multiple myeloma are generally older and vary in fitness levels, which may influence the clinical benefit of treatment. Patients from the large, phase 3 FIRST trial in newly diagnosed multiple myeloma (NDMM) were retrospectively investigated to determine outcomes based on frailty using scores:

instead of the EQ-5D quality-of-life questionnaire, as previously reported.

ECOG PS (n = 1618) was investigated in frailty groups: frail (49%) and nonfrail (51%).

  • Frail patients experienced worse progression-free and overall survival vs nonfrail patients.
  • Prognostic assessment was improved when combining frailty and International Staging System stage (I/II vs III).
  • Frail patients had a higher risk of developing grade 3/4 treatment-emergent adverse events.

Treatment effects observed in the FIRST trial were confirmed per frailty group and per frailty and ISS group. The use of this ECOG PS–containing frailty scale as a predictive measure of clinical outcomes in patients with transplant-ineligible NDMM is supported by data from the FIRST trial. This score, based on age, CCI, and ECOG PS, can be easily replicated and may help design future myeloma studies in frail or nonfrail elderly patients.”

Leave a Comment: