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.
“And, since “[t]here were no new safety concerns,” the results “support the frontline use of (myeloma triplet) daratumumab plus lenalidomide and dexamethasone” for patients with MM who are ineligible for transplantation…”
First and foremost, I have to go on record as saying that the clinical trial for a myeloma triplet chemo regimen is talking about a real breakthrough for newly diagnosed myeloma patients.
Keep in mind that I am usually anti-toxicity. That is to say, I believe that people should undergo as little toxicity as possible. Further, I think that patients should
Pre-habilitate
Exercise
Supplement
Etc. Before, during and after conventional therapy.
However, with an induction therapy that can provide half (52%) of patients with a five year first remission (PFS), it means that these patients undergo a lot less toxicity that newly diagnosed myeloma used to undergo when undergoing multiple regimens in the first five years of their life as myeloma patients.
The next “unusual aka unheard of” item in the clinical trial below is tracking or citing improvement not only in progression-free survival (PFS) but also overall survival (OS). If you are a NDMM patient do you want to talk about your first remission (PFS) or how long you will live (OS)???
Next and probably the most important issue is that this induction therapy is offering less toxicity meaning fewer adverse events AND a longer PFS, OS.
So let’s get specific:
If the NDMM patient begins his/her MM journey with a relatively safe induction therapy that takes him/her for a 5 or 6 year first remission
then another several years of relapsed, refractory therapies, (proteasome inhibitors such as Velcade, Kyprolis, Ninlaro???)
and then we bring in the heavy hitting therapies such as CAR-T cell therapy?
Don’t forget that I am sketching out ten plus years of easy therapy plans above. Who knows what will come along over the next ten years…
As and aside, two of the greatest MM specialists, Robert Kyle and S. Vincent Rajkumar were both quoted as raving about this triplet therapy. Those two M.D.’s add real credibility to this finding as far as I’m concerned.
Median PFS with daratumumab/lenalidomide/dexamethasone may exceed 5 years
“Triple-agent treatment led to skyrocketing overall survival (OS) and progression-free survival (PFS) in patients with newly diagnosed multiple myeloma (MM) who were ineligible for stem-cell transplantation, according to updated results from the MAIA trial…
In the ongoing phase III trial, median OS was not reached in patients who received a regimen of daratumumab/lenalidomide/dexamethasone and neither was median PFS at 56.2 months…
And, since “[t]here were no new safety concerns,” the results “support the frontline use of daratumumab plus lenalidomide and dexamethasone” for patients with MM who are ineligible for transplantation, the authors wrote. In addition, given the estimated 60-month PFS of 52.5% (95% CI 46.7 to 58.0) in the daratumumab group, the median PFS “is anticipated to be more than 5 years, which, to our knowledge, would be unprecedented” in this patient population, they emphasized…
“The best regimens we’ve had so far have provided a median PFS of around 3 years… with either the combination bortezomib [Velcade], lenalidomide, and dexamethasone, the so-called VRd, or the combination of daratumumab, bortezomib, melphalan, and prednisone, the so-called dara-VMP. This [MAIA] regimen has moved the PFS from to 3 years to 5 years.”
MAIA co-investigator Aurore Perrot, MD, of the University of Toulouse, called the PFS results “incredible” in a VJHemOnc interview at the 2020 ASH meeting. San-Miguel noted to VJHemOnc in 2021 that, based on MAIA and ALCYONE, “the impact of achieving MRD negativity is important… if you combine both studies…[they] reinforce the predictive value of achieving MRD negativity and, what is more important, to sustain MRD…”
Both POLLUX and CASTOR in the New England Journal of Medicine (NEJM) demonstrated that “[d]aratumumab represents a landmark advance in the treatment of myeloma. It is likely to be incorporated into the treatment of all stages of the disease over the next several years,” according to S. Vincent Rajkumar, MD, and Robert A. Kyle, MD, both of the Mayo Clinic in Rochester, Minnesota, in an accompanying NEJMeditorial…
They advised that daratumumab/lenalidomide/dexamethasone should be the go-to treatment for “first relapse in patients whose disease is not refractory to lenalidomide… the magnitude of benefit is impressive, and the regimen is relatively easy to administer, especially after the first 6 months of therapy…”
Daratumumab is a human immunoglobulin-κ monoclonal antibody that targets CD38 with a direct on-tumor and immunomodulatory mechanism of action, Facon’s group explained. The agent is FDA approved, as monotherapy and in combination with standard-of-care regimens, in newly diagnosed MM and relapsed or refractory MM…”
Greetings David! So I ended up switching Oncologist after 1.5 years for my Dad as I was not satisfied with his prognosis and double talk. He wanted to perform another Biopsy on my Dad saying he did not know how much cancer he has in his bones. Skeptical, we went for a second opinion. The new Oncologist said he saw no evidence or reason for another biopsy. All the blood data was enough. He is prescribing my Dad get back on Revlimid (5mg), Acyclovir (400mg), Dexamethadone (20mg), Xgeva and Darzalex. I just saw that I missed your Thursday talk and you spoke about your concerns. Is there a problem with Darzalex?
They used this triple drug treatment on my husband, even though he is transplant eligible. He went into remission after 12 days. Just two shots of the DARA. Why do they say they only use this on transplant ineligible people?
That is a good question. All I can say is that I will be following this study, this triplet in the future. Please keep me posted on your husband’s further progress.
My guess is that his oncologists believe his numbers can continue to fall, become normal with more therapy. At least the therapy is less toxic than many other therapies. According to that study this combo should result in a first remission of about five years on average.
