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 a line of therapy in myeloma? Myeloma patients may need to know how many lines of therapy (LOT) they’ve undergone when considering their overall treatment plan, including which regimens they may be refractory to.
Boy, do I disagree with Dr. Nadeem in the video below. Dr. Nadeem considers induction, ASCT, consolidation, maintenance therapy ALL to be one line of therapy.
I disagree vehemently with Dr. Nadeem for several reasons. Primarily, Dr. Nadeem’s first LOT is a ton of toxicity. Yikes! This much toxicity is sure to cause a host of short-term, long-term, and late-stage side effects for many of the patients. This isn’t too much of a surprise because conventional oncology does pay much attention to side effects aka quality of life.
Depending on the study you are focusing on, as many as a third of all NDMM patients alter their induction therapy.
What Really Counts as a Line of Therapy in Myeloma—and Why It Matters for You
I am a long-term MM survivor and MM cancer coach. Most MM patients I talk to struggle with side effects. As a result of this struggle, patients alter the doses, frequency, etc. of many of their chemo regimens.
As MM survivors live longer lives, they may undergo more chemotherapy. Or by my way of thinking, MM survivors will undergo more lines of therapy. I think MM survivors will want to be specific when measuring their LOT.
Please email me at David.PeopleBeatingCancer@gmail.com to learn more about both the pros and cons of conventional and non-conventional MM therapies.
Prior treatments in multiple myeloma (MM) have traditionally been described using lines of therapy (LOT) [1]. A LOT is defined as one or more complete cycles of a single/combination of agents, or a planned sequential therapy consisting of several regimens [1].
The number of LOT that a patient has received does influence outcomes seen with subsequent therapies [1–3], and has been used to determine inclusion in clinical trials for relapsed/refractory multiple myeloma (RRMM) [4–9].
It has been considered as a reliable measure of prior treatments and is often used to compare results from different treatment regimens and to guide approval of new agents for the treatment of MM.
However, classification based on LOT is prone to several limitations. Although RRMM trials have considered LOT for stratifying patients [5–9], this practice assumes a uniform definition for lines of therapy [1, 10]. In reality, patients with the same number of prior lines might have received vastly different regimens, a heterogeneity that will only grow with an increasing number of available drugs. This limits the ability to compare results across different RRMM trials.
Further, a LOT can change for several reasons other than disease progression—e.g., toxicity, end of planned therapy, inadequate response to therapy, etc. [1]; which are more dependent on practice patterns than disease biology.
The increasing number of treatment options and different permutations and combinations of drugs makes it difficult to understand the actual significance of the number of prior lines received, owing to variability in what constitutes a line [11].
We hypothesized that a more meaningful and reliable way would be to define prior therapy by the number of drugs or the number of drug classes that a patient is refractory to, which could better reflect the disease biology…
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2 comments
Tricia ellis says
a couple of months ago
It woujd help to have specific described. I think I am different. 78 diagnosis 5 years ago take pomalyst and get an injection once a month of fastpro
I’m told u have long covid. That affecting my breathing. In heart medicine and blood thinner. Thyroid meds for years same. with Prozax Biggest complaint is fatigue. I just wondered if anyone else similar. I have not had cell replacement
Hi Tricia- The post that you are referring to offers two different definitions of line of therapy. Further, your health challenges are beyond what the post is talking about.
