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.
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What Comes After BCMA therapies?
Dear David- What comes after BCMA therapies? So BCMA treatments do not include the DVRd treatments we all start out with, correct?
Seems like the plant-based diet is the best defense against relapse, since it keeps our bodies more alkaline as opposed to acidic. And, it seems cancers love acid environments. That’s where my focus is.
I’m not too good with mega doses of supplements bc they interfere with my digestion.
Also, exercise every day is paramount for me. Any other thoughts on keeping the monster at bay? Chris-
Hi Chris-DVRd is the FDA standard-of-care cocktail for “induction therapy” for all newly diagnosed MM patients. The FDA then recommends an ASCT followed by low dose maintenance therapy.
Those three therapy steps are the only recommendations that the FDA makes. When a MM patient relapses after the SOC therapy plan, they are considered to be relapsed/refractory aka RR/MM.
MM patients then work with their onc to undergo more chemo cocktails for remissions, relapses, etc.
“B-cell maturation antigen” or BCMA is the general term for therapies that are designed to kill MM by being attracted to b-cells on the surface of MM cells.
Anit-BCMA therapies are relatively new and are only approved for RR/MM patients. Often these RR/MMc patients have already undergone many rounds of therapies. So anti-BCMA can be the patient’s last hope.
So the question becomes, what, if any therapies can the patient undergo if they relapse after CAR-T cell therapy for example.
Thought not FDA approved therapies, I agree that non-conventional therapies such as nutrition can enhance remission while enhancing the MM patient’s quality of life.
I am continually amazed by conventional oncology. Sure conventional therapies bring a host of short, long-term and late stage side effects but oncology trials and approved regimen after regimen. When I was first diagnosed, average life expectancy was 3-5 years. NDMM patients are now living 10 years or more.
Email me at David.PeopleBeatingCancer@gmail.com if you have any questions.
Good luck,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Teclistamab Yields Durable Responses in MM Patients With Prior Anti-BCMA Treatment
“Teclistamab produced “clinically meaningful” responses in patients with heavily pretreated multiple myeloma (MM) who had received prior anti-BCMA treatment, according to researchers.
These results, published in Blood, come from cohort C of the phase 1/2 MajesTEC-1 trial (NCT03145181; NCT04557098).
The cohort included 40 patients with relapsed/refractory MM. At baseline, the patients’ median age was 64 (range, 32-82) years, 62.5% of patients were men, 30.0% had at least 1 extramedullary plasmacytoma, and 33.3% had high-risk cytogenetics.
- Patients had received a median of 6 prior lines of therapy (range, 3-14).
- All patients were triple-class-exposed, and 85% were triple-class refractory.
- Eighty percent of patients were penta-drug-exposed, and
- 35% were penta-refractory.
All patients had received at least 1 prior anti-BCMA treatment, including:
- an antibody drug conjugate (ADC; 72.5%)
- and chimeric antigen receptor (CAR) T-cell therapy (37.5%).
- (Four patients had received both an ADC and CAR T-cell therapy.)
On study, patients received subcutaneous teclistamab. They received an initial step-up dose of 0.06 mg/kg, a second step-up dose of 0.3 mg/kg, and a first treatment dose of 1.5 mg/kg weekly.
Patients could reduce dosing to every 2 weeks if they had a complete response (CR) lasting at least 6 months. Patients also received prophylaxis for cytokine release syndrome (CRS).
The median follow-up was 28.0 months, and the median duration of teclistamab treatment was 6.0 months. Reasons for treatment discontinuation included disease progression (n=21), death (n=9), adverse events (n=3), physician decision (n=2), and patient refusal (n=1).
The overall response rate (ORR) was 52.5%, the rate of very good partial response (VGPR) or better was 47.5%, and the rate of CR or better was 30.0%.
The ORR was 55.2% in patients who had received prior treatment with a BCMA-targeted ADC and 53.3% in those who had received BCMA CAR T-cell therapy. The rate of VGPR or better was 48.3% and 46.7%, respectively. The rate of CR or better was 27.6% and 26.7%, respectively.
The researchers noted that responses were durable and deepened over time. The median duration of response was
- 14.8 months overall,
- 14.4 months among patients who had received prior CAR T-cell therapy, and
- 14.8 months among patients who had received an ADC.
The median progression-free survival was 4.5 months overall, 4.4 months among patients who had received prior CAR T-cell therapy, and 7.3 months among patients who had received an ADC.
The median overall survival was
- 15.5 months overall,
- 14.9 months among patients who had received prior CAR T-cell therapy, and
- 16.0 months among patients who had received an ADC.
All patients had at least 1 treatment-emergent adverse event. The most common hematologic adverse events were neutropenia (70.0%), anemia (50.0%), lymphopenia (45.0%), and thrombocytopenia (45.0%).
The most common non-hematologic adverse events were infections and infestations (70.0%), CRS (65.0%), constipation (37.5%), diarrhea (37.5%), pyrexia (35.0%), injection site erythema (32.5%), arthralgia (27.5%), neurotoxicity (27.5%), and COVID-19 (25.0%).
All cases of CRS were grade 1-2 and resolved without the need to end teclistamab treatment. Most cases of neurotoxicity (61.5%) resolved, or patients recovered.
Two deaths were considered related to treatment. One was due to COVID-19, and the other was due to cardiac arrest. A total of 4 patients died of COVID-19. Three of the patients had received at least 1 dose of a COVID-19 vaccine, and 1 patient had no record of COVID-19 vaccination.
“Teclistamab provides clinically meaningful responses in patients with RRMM with prior anti-BCMA treatment,” the researchers noted. “Responses occurred early, deepened over time, and were durable. These results are important for clinicians regarding the potential clinical benefit of teclistamab following prior anti-BCMA therapy, as previous exposure to such therapies is becoming more prevalent among patients with RRMM.”
Disclosures: This research was supported by Janssen. Some study authors disclosed conflicts of interest. Please see the original reference for complete disclosures.
This article originally appeared on Cancer Therapy Advisor