I completed an advanced multiple myeloma related course this morning, Relapsed/Refractory Multiple Myeloma: Options for Subsequent Therapy: Optimal Management Strategies and Novel Agents in Multiple Myeloma,
By: Amitabha Mazumder, MD. Dr. Mazumder is Professor of Medicine at NY Medical College.
Here are some of the basic points from the coursework:
A new patient response category, stringent complete response (sCR) has been developed to more accurately monitor a patient’s response to the induction phase of their treatment.
Another change is the modification of the very good partial response (VGPR) classification to only include patients with a 90%+ reduction in their M protein spike.
Adding doxorubicin to Velcade or Revlimid increases refractory response rates.
Combining Velcade and Revlimid increases response rates. Here are some detailed notes from the course:
Would lenalidomide plus bortezomib have synergism? In this trial, Richardson and colleagues were able to show approximately an 80% to 85% response rate in patients with relapsed/refractory myeloma. Interestingly, this included responses in patients with prior bortezomib or lenalidomide experience. Therefore, there does appear to be a true response synergism, including approximately 65% to 70% of patients who have VGPR and good responses and including patients who have high-risk cytogenetics. Consequently, this is one of our preferred regimens in patients who have high-risk cytogenetics. This regimen also has potential for use as a maintenance regimen.
Lots and lots of information about how to deal with potential side effects, caused by the before mentioned drugs and drug combinations.
Discussion of existing and new clinical studies was also extensive. Let’s take a careful look at those tomorrow.
Feel good and keep smiling! Pat