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.
What is the goal of myeloma induction therapy? To reduce the newly diagnosed myeloma patients’ MM, of course, but there is more to induction therapy these days than controlling the NDMM patients’ MM.
The main challenge is that MM is incurable. NDMM patients undergo therapy regimen after therapy regimen, experiencing remissions and relapses. Because more than half of all MM deaths are due to infection, the NDMM patient must manage their immune system while they manage their MM.
My point is that induction therapy is a short-term solution to a long-term problem (multiple myeloma). How is the newly diagnosed MM patient supposed to juggle the short-term needs with the long-term challenges?
The chronological listing of induction therapies below illustrates how conventional oncology has steadily increased NDMM patients’ overall response rates (ORR) as well as increasing the percentage of NDMM patients who reach a deep remission aka MRD negative status.
What the listing of induction regimens does not discuss are the percentage of NDMM patients who don’t respond well to DVRd or VRD but are pushed by their oncologist to undergo other regimens in order to hopefully achieve a deep remission.
Yes, there is a correlation between deep remission and first remission and length of life. However, too much chemo is too much toxicity and therefore damages the NDMM patients’ immune system making them more susceptible to infection.
Infection, as we know, can lead to death in MM survivors.
What are the goals of induction therapy (your first treatment) in myeloma?
Dara-VRd (Daratumumab + VRd)– increasingly used for transplant-eligible and ineligible patients:
ORR: >95%
CR/sCR (Stringent Complete Response): Higher rates, often >40%
The average overall response rate (ORR) for newly diagnosed multiple myeloma patients undergoing Vincristine + Doxorubicin + Dexamethasone (VAD) chemotherapy has historically ranged between 50% and 60%.
Unfortunately, VAD is clearly more toxic and less effective than today’s induction regimens. Compared with modern triplets/quadruplets, VAD causes more hematologic toxicity, infections, anthracycline-related risks, and (historically) more treatment-related deaths; modern regimens shift the main toxicity toward manageable, schedule-dependent peripheral neuropathy (from bortezomib) and, with daratumumab, higher rates of neutropenia.
Here is a chronological overview of FDA-approved standard-of-care induction therapy regimens for newly diagnosed multiple myeloma (NDMM) patients in the United States from 1994 to 2025.These regimens have evolved significantly, incorporating novel agents and combination therapies to enhance treatment efficacy and patient outcomes.The Oncology Nurse+1Sanofi+1
1990s–Early 2000s: Alkylator-Based Regimens
Melphalan + Prednisone (MP): The longstanding standard for transplant-ineligible patients.ASCO Publications
Vincristine + Doxorubicin + Dexamethasone (VAD): Commonly used for transplant-eligible patients prior to the advent of novel agents.
Bortezomib + Dexamethasone (VD): Marked the introduction of proteasome inhibitors (PIs) into induction therapy.
Bortezomib + Thalidomide + Dexamethasone (VTD): Demonstrated superior response rates compared to TD, establishing a new standard for transplant-eligible patients.The ASCO Post+4ASCO Publications+4OncLive+4
Bortezomib + Cyclophosphamide + Dexamethasone (VCD): Offered high response rates with reduced neurotoxicity compared to VTD, making it a preferred option in many regions.The Oncology Nurse+3ASCO Publications+3Medscape+3
2010s: Emergence of Lenalidomide-Based Regimens
Bortezomib + Lenalidomide + Dexamethasone (VRd): Became a widely accepted standard for both transplant-eligible and -ineligible patients due to its efficacy and manageable toxicity profile.ASCO Publications+3OncLive+3The Oncology Nurse+3
Daratumumab + Bortezomib + Thalidomide + Dexamethasone (D-VTd): Approved in 2019 for transplant-eligible patients based on improved response rates and progression-free survival (PFS) demonstrated in the CASSIOPEIA trial.OncLive+1Medscape+1
2020s: Quadruplet Regimens and Monoclonal Antibodies
Daratumumab + Lenalidomide + Dexamethasone (D-Rd): Approved for transplant-ineligible patients, showing superior PFS and minimal residual disease (MRD) negativity rates compared to Rd alone.ASCO Publications+1International Myeloma Foundation+1
Daratumumab + VRd (D-VRd): Established as a new standard for transplant-eligible patients following the PERSEUS trial, which demonstrated significant improvements in depth of response and long-term disease control.The Oncology Nurse+2International Myeloma Foundation+2The ASCO Post+2
Isatuximab (Sarclisa) + VRd: Approved in 2024 for transplant-ineligible patients based on the IMROZ study, which showed a 40% reduction in the risk of disease progression or death compared to VRd alone.Reuters+2The Oncology Nurse+2Medscape+2
Isatuximab + Carfilzomib + Lenalidomide + Dexamethasone (Isa-KRd): Investigated in the IsKia trial for transplant-eligible patients, showing promising results in terms of efficacy and safety.The ASCO Post+1OncLive+1
These advancements reflect a significant shift towards incorporating monoclonal antibodies and quadruplet regimens in the frontline treatment of NDMM, aiming to improve patient outcomes through deeper and more durable responses.
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Genie says
last month
What everyday suppliments and other things to prolond my life ?
I need to know if you are a MM survivor or not. If you are a MM survivor, I assume you are asking about nutritional supplements that are cytoxic to MM?
