Does any one know of alternatives to Velcade?
Tom
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Tom74 - Name: Tom Meredith
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 9/5/15
- Age at diagnosis: 73
Re: What are the alternatives to Velcade?
I was just reading about someone who said he was allergic to Velcade and was switched to Revlimid.
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cdnirene - Name: Irene S
- Who do you know with myeloma?: me
- When were you/they diagnosed?: September 2014
- Age at diagnosis: 66
Re: What are the alternatives to Velcade?
Hello Tom:
Simple question, but the answer depends on a number of things. Primarily, if it's initial induction or relapse; whether or not it's maintenance; or if you are on reduced dosing due to age / health.
As CdnIrene stated, people on a two-drug regimen have switched out between Revlimid and Velcade, depending on which one works better or on side effects.
The next proteasome inhibitor up is Kyprolis. Kyprolis is FDA approved for relapsed multiple myeloma, however, I have observed that only in the last few months several locations have started it in the upfront setting. That would be "off-label". The issue with off-label proscribing is that often there are insurance issues. Refer for example to the updated MSmart guidelines. So Kyprolis is a possibility in both relapsed and newly diagnosed.
The newest proteasome inhibitor is ixazomib (Ninlaro), which is a pill. It is approved for relapsed / refractory myeloma. It is so new, that I do not think any insurance company would pay for its use in newly diagnosed patients at this time. Lastly, if you look at the MSmart guidelines, the elotuzumab (Empliciti)-Revlimid-dex combo is used in relapsed multiple myeloma, so you could think of that as a potential substitute as well.
Good luck
Simple question, but the answer depends on a number of things. Primarily, if it's initial induction or relapse; whether or not it's maintenance; or if you are on reduced dosing due to age / health.
As CdnIrene stated, people on a two-drug regimen have switched out between Revlimid and Velcade, depending on which one works better or on side effects.
The next proteasome inhibitor up is Kyprolis. Kyprolis is FDA approved for relapsed multiple myeloma, however, I have observed that only in the last few months several locations have started it in the upfront setting. That would be "off-label". The issue with off-label proscribing is that often there are insurance issues. Refer for example to the updated MSmart guidelines. So Kyprolis is a possibility in both relapsed and newly diagnosed.
The newest proteasome inhibitor is ixazomib (Ninlaro), which is a pill. It is approved for relapsed / refractory myeloma. It is so new, that I do not think any insurance company would pay for its use in newly diagnosed patients at this time. Lastly, if you look at the MSmart guidelines, the elotuzumab (Empliciti)-Revlimid-dex combo is used in relapsed multiple myeloma, so you could think of that as a potential substitute as well.
Good luck
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JPC - Name: JPC
Re: What are the alternatives to Velcade?
Thanks, I see the oncologist January 7, 2016 and will post my new treatment. Velcade was affecting my nervous system and the doctor said the damage is non reversible.
Happy holidays
Tom74
Happy holidays
Tom74
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Tom74 - Name: Tom Meredith
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 9/5/15
- Age at diagnosis: 73
Re: What are the alternatives to Velcade?
Doctor decided to keep me off chemo. My next visit is 4 weeks. Meds manage pain and doctor said blood work looks good.
So now on Revlimid and dex until I see him in February. With the dex, have feet and leg swelling, but wear compression socks daily and it helps a lot. If swelling gets worse, take Lasix.
Stay positive,
Tom74
So now on Revlimid and dex until I see him in February. With the dex, have feet and leg swelling, but wear compression socks daily and it helps a lot. If swelling gets worse, take Lasix.
Stay positive,
Tom74
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Tom74 - Name: Tom Meredith
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 9/5/15
- Age at diagnosis: 73
Re: What are the alternatives to Velcade?
Hi Tom,
Just wondering how Velcade is affecting your nervous system? Any other side effects?
My father's doc is planning to give Velcade to my father and I am very nervous about it.
Thank you
Just wondering how Velcade is affecting your nervous system? Any other side effects?
My father's doc is planning to give Velcade to my father and I am very nervous about it.
Thank you
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Tina28 - Name: Tina28
- Who do you know with myeloma?: My father
- When were you/they diagnosed?: September 2015
- Age at diagnosis: 61
Re: What are the alternatives to Velcade?
Tom,
I, too, would like to know how Velcade affects your nervous system. Is it in ways different from the usual peripheral neuropathy people complain about with this drug?
I, too, would like to know how Velcade affects your nervous system. Is it in ways different from the usual peripheral neuropathy people complain about with this drug?
Re: What are the alternatives to Velcade?
From what I undersand, Ninlaro is similar in composition to Velcade, although in pill form.
Here in Ontario, the approved therapy is cyclophosphamide, Velcade (bortezomib), and dexamethasone. Second line is Revlimid and dex. Third line is Pomalyst (pomalidomide).
Here in Ontario, the approved therapy is cyclophosphamide, Velcade (bortezomib), and dexamethasone. Second line is Revlimid and dex. Third line is Pomalyst (pomalidomide).
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Little Monkey - Name: Little Monkey
- Who do you know with myeloma?: Father-stage 1 multiple myeloma
- When were you/they diagnosed?: March/April of 2015
Re: What are the alternatives to Velcade?
The Velcade got into my nervous system and gave me full blown peripheral neuropathy. Pain in chest, back, arms, feet, and hands. The pain is not manageable with pain pills. Went to see pain specialist and he put me on methadone and Cymbalta (duloxetine). It took about a week to start working, but it does relieve the pain except for hands and feet?
Side effects are fatigue, stomach problem,s and problems with walking (dizziness).
My new chemo is Kyprolis. Take it twice a week for three weeks and then off a week. It also upsets your stomach, fatigue, etc. With the pain management I am doing 100% better.
Stay positive and good luck
Tom74
Side effects are fatigue, stomach problem,s and problems with walking (dizziness).
My new chemo is Kyprolis. Take it twice a week for three weeks and then off a week. It also upsets your stomach, fatigue, etc. With the pain management I am doing 100% better.
Stay positive and good luck
Tom74
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Tom74 - Name: Tom Meredith
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 9/5/15
- Age at diagnosis: 73
Re: What are the alternatives to Velcade?
I had the dexamethasone and Revlimid pills, and Velcade stomach shots, last year after a broken arm with myeloma. The Velcade has affected me badly below the knees, and while I know there are not many choices, I would resist taking Velcade again. I am on 5 mg Revlimid maintenance now and my feet are slowly getting better. Am Taking Percocet (acetaminophen / paracetamol and oxycodone) daily.
No easy answers. The two weeks for the stem cell transplant in November weren't too bad. All in all, am pretty good now.
No easy answers. The two weeks for the stem cell transplant in November weren't too bad. All in all, am pretty good now.
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David Brickner
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