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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.

Safely Discontinue Myeloma Maintenance

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As with all things myeloma, the decision to safely discontinue myeloma maintenance therapy is based on risk or the odds of your MM returning. Let me explain.

As you read the info below, keep these 4 things in mind-

  1. Low-dose maintenance  therapy is the third leg (induction, ASCT and LDM) of the FDA standard-of-care therapy plan for all newly diagnosed MM patients-
  2. While the FDA stipulates LDM, it does not stipulate how long the NDMM patient should undergo LDM
  3. The study below is talking about minimal residual disease aka MRD only-
  4. The study measures MRD whenever it is reached. Some MM patients reach MRD after only a few months of induction.

What are the pros and cons of low-dose maintenance therapy for myeloma patients?

Pros

  1. Prolonged Remission:
    • Maintenance therapy can help extend the period of remission by continuing to suppress the myeloma cells that remain after initial therapy. Studies have shown that it can lengthen progression-free survival (PFS).
  2. Improved Overall Survival:
    • Some clinical trials have indicated that low-dose maintenance therapy can improve overall survival rates in myeloma patients.
  3. Better Disease Control:
    • Continuous low-dose therapy helps in keeping the disease under control and can delay the need for more aggressive treatments.
  4. Reduced Relapse Rate:
    • Maintenance therapy has been associated with a lower rate of relapse, helping patients maintain a higher quality of life for a longer period.
  5. Potential for Minimal Residual Disease (MRD) Eradication:
    • Maintenance therapy might contribute to eradicating MRD, which is linked to better long-term outcomes.

Cons

  1. Side Effects:
    • Even at low doses, maintenance therapy drugs can cause side effects such as fatigue, gastrointestinal issues, infections, neuropathy, and blood clots. The chronic nature of these side effects can affect patients’ quality of life.
  2. Drug Resistance:
    • Prolonged exposure to the same medication can lead to the development of drug resistance, making future treatment more challenging.
  3. Cost:
    • The ongoing cost of maintenance therapy can be substantial, posing a financial burden on patients and healthcare systems.
  4. Impact on Quality of Life:
    • The side effects and the need for continuous medication can impact the daily life of patients, making it difficult for some to maintain their usual activities and lifestyle.
  5. Treatment Fatigue:
    • The need for ongoing treatment without a clear endpoint can lead to psychological fatigue and a sense of being perpetually in treatment, which can affect mental health.
  6. Risk of Secondary Malignancies:
    • Long-term use of certain maintenance drugs has been linked to an increased risk of secondary malignancies, although this risk is generally low.

My takeaway of the study below is that if the NDMM patient is fortunate enough to reach MRD, they can stop therapy and be fairly confident that they will enjoy a longer than average first remission.

I am a MM survivor who lives with a host of long-term and late stage side effects. As you can imagine, I am biased toward less risk of side effects. Meaning, the sooner NDMM patients discontinue LDM, the lower the risk of side effects and the higher the quality of life.

As for NDMM patients who do not reach MRD, my guess would be that their oncologists will encourage them to remain on LDM for years if not forever. I firmly believe that it is up to the patient to weigh the risks and benefits of LDM in order to make their decision for how long, how high or low a dose, etc.

Are  you a NDMM patient contemplating low-dose maintenance therapy? How much, how long, etc? I purposely have not mentioned evidence-based non-conventional therapies that may benefit the NDMM patient. If you would like to learn more email me at David.PeopleBeatingCancer@gmail.com

Good luck,

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

How to Safely Discontinue Multiple Myeloma Maintenance Care

Multiple myeloma specialists have long questioned whether patients who respond well to upfront treatment need to be on maintenance therapy indefinitely, which is often the usual practice…

Research presented at the ASCO annual meeting showed that most patients with multiple myeloma can safely discontinue maintenance therapy if they have undetectable residual disease…

The majority of patients (85%) with undetectable residual disease at baseline were progression-free 3 years after discontinuing maintenance therapy, and that percentage improved even further to 93% when using a more sensitive test to detect measurable residual disease (MRD)…

Overall, the 3-year progression-free survival (PFS) was 85% among 47 patients who stopped maintenance when they were clear of residual cancer cells down to a sensitivity of 10−6

High-risk cytogenetics was also associated with worse MRD-free survival…

Two patients (of the 47 total)  developed secondary hematologic cancers — Hodgkin lymphomaand B-cell acute lymphoblastic leukemia. The patient with lymphoblastic leukemia died 2 years after discontinuation, the only death in the study…

By avoiding the considerable side effects of ongoing maintenance therapy with lenalidomide — which can include insomnia, diarrhea, pain, and secondary cancers — patients’ quality of life improved, and, overall, patients saved about $22.5 million on the cost of lenalidomide over 3 years…

 

 

 

 

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