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.
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Relapsed/Refractory Multiple Myeloma (RRMM) chemotherapy regimens must be looked at holistically. That is to say a RRMM survivor must consider adverse events (AE) as well as cost as well as efficacy. The study linked and excerpted below does this.
As a MM survivor myself, I would add that RR/MM survivors must look at their situation historically as well.
While I appreciate the sentiment of the research linked and excerpted below, my experience is that RR/MM survivors are hoping for overall survival more than “prior responsiveness, prior AE” etc.
Knowing this, consider the information below pointing to enhancing chemo responsiveness.
I understand that multiple myeloma survivors may be apprehensive to undergo any therapy that is not FDA approved and prescribed by their oncologist. The dilemma, as I see it anyway, is that tens of thousands of RR/MM survivors have died since I was diagnosed with multiple myeloma in early 1994.
If you view your situation as a multiple myeloma patient historically, you will see failure of conventional MM oncology.
The usual RR/MM survivor is older, has lived through a host of short, long-term and late stage side effects from previous conventional therapy regimens. History clearly demonstrates that continuing conventional therapies will have the same result.
Are you a relapsed/refractory multiple myeloma survivor? To learn more about evidence-based, non-conventional, integrative therapies scroll down the page, post a question or comment and I will reply to you ASAP.
Hang in there,
“The choice of regimen is usually based on prior responsiveness, drugs already received, prior adverse effects, the condition of the patient and expected effectiveness and tolerability…”
“A Bayesian network, Bayes network, belief network, decision network, Bayes(ian) model or probabilistic directed acyclic graphical model is a probabilistic graphical model (a type of statistical model) that represents a set of variables and their conditional dependencies via a directed acyclic graph (DAG). Bayesian networks are ideal for taking an event that occurred and predicting the likelihood that any one of several possible known causes was the contributing factor…”
“In this systematic review published in Cancer, researchers looked at the associations of the efficacy of each approved treatment regimen for relapsed and/or refractory multiple myeloma with adverse events (AEs) and the total cost per cycle compared with a Bayesian network meta-analysis of phase III randomized controlled trials (RCTs)…
“To our knowledge, this is the first [network meta-analysis] that has indirectly evaluated the efficacy, safety, and total treatment cost of a myriad of approved [relapsed and/or refractory multiple myeloma] regimens using phase III RCTs,” the authors wrote…
Using Scopus, Cochrane, PubMed Publisher, and Web of Science, researchers searched for phase III RCTs of regimens approved by the FDA for relapsed and/or refractory multiple myeloma from January 1999 to July 2018.
Moreover, the primary efficacy, safety, and cost outcomes were identified as progression-free survival with the regimen, grade 3 to 4 AEs, and the total cost per cycle (regiment cost plus average cost of managing AEs).
Overall, 15 studies of 7,718 patients evaluating 14 different regimens were identified.
were ranked highest for reducing progression, but carried the highest probability of total cost per cycle
were found to be the least effective and least safe, whereas bortezomib, thalidomide, and dexamethasone emerged as the least effective with the highest total cost per cycle.
Carfilzomib and dexamethasone appeared to be the winner though when this regimen was considered in terms of efficacy and safety and efficacy and total cost per cycle…
“Several new treatment options have been approved for relapsed and/or refractory multiple myeloma (RRMM). In this systematic review, associations of the efficacy of each approved regimen with adverse events (AEs) and the total cost per cycle were compared with a Bayesian network meta-analysis (NMA) of phase 3 randomized controlled trials (RCTs).
METHODS: Scopus, Cochrane, PubMed Publisher, and Web of Science were searched from January 1999 to July 2018 for phase 3 RCTs of regimens (approved by the US Food and Drug Administration) used in RRMM. The relative ranking of agents was assessed with surface under the cumulative ranking (SUCRA) probabilities. The primary efficacy, safety, and cost outcomes were progression-free survival with the regimen, grade 3 to 4 AEs, and the total cost per cycle (regimen cost plus average cost of managing AEs).
RESULTS: Fifteen studies including 7718 patients and evaluating 14 different regimens were identified.
were ranked highest for reducing progression,
1) but carried the highest probability of total cost per cycle ($41,420; 95% Credible Interval [CrCl], $58,665-$78,041; SUCRA, 0.02).
were the least effective and least safe, whereas
emerged as least effective with the highest total cost per cycle.
emerged as the winner when this regimen was considered in terms of efficacy and safety and efficacy and total cost per cycle.
CONCLUSIONS: The results of this NMA can provide additional guidance for the decision-making process when one is choosing the most appropriate regimen for RRMM.”