My mother's multiple myeloma was out of control 3 years ago but Darzalex worked in different combinations for 3 years. Now her kappa light chains are almost 10,000. One doctor told her to go straight to hospice and the other one said to try Empliciti, Velcade, cyclophosphamide, and dexamethasone.
If we go with this regimen, what can we expect in terms of efficacy and side effects?
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Re: Empliciti, Velcade, cyclophosphamide & dexamethasone
Hi Jess,
I'm sorry to hear about the relapse your mother is experiencing.
At first glance, one wouldn't necessarily think that the combination you've described (elotuzumab, bortezomib, cyclophosphamide, and dexamethasone) would do all that much. It usually is assumed that elotuzumab (Empliciti) works mainly in combination with "immunomodulatory" drugs such as Revlimid, Pomalyst, and thalidomide.
However, there was a trial done a couple of years ago showing that elotuzumab and bortezomib is actually a promising combination. Here is a link to the study,
https://www.ncbi.nlm.nih.gov/pubmed/27091875
and the Beacon also has an article that discusses it in some detail:
https://myelomabeacon.org/news/2016/04/19/myeloma-morning-empliciti-velcade-dexamethasone-treanda/
Also, cyclophosphamide often is used in heavily pretreated patients because some patients seem to respond to it. And, of course, cyclophosphamide often is combined with dexamethasone and bortezomib as either "VCD" or "CyBorD".
So there are several reasons your mother's doctors might want to pursue the regimen you described. The trick, of course, will be to administer the regimen in a way that is not too harsh for her (i.e., keep the side effects under control). Her doctors might choose, for example, to ramp up the dosage of the different medications, rather than give them at high doses right away. Or they may choose to give her medications to counteract potential side effects before they occur.
Good luck, and please keep us updated.
I'm sorry to hear about the relapse your mother is experiencing.
At first glance, one wouldn't necessarily think that the combination you've described (elotuzumab, bortezomib, cyclophosphamide, and dexamethasone) would do all that much. It usually is assumed that elotuzumab (Empliciti) works mainly in combination with "immunomodulatory" drugs such as Revlimid, Pomalyst, and thalidomide.
However, there was a trial done a couple of years ago showing that elotuzumab and bortezomib is actually a promising combination. Here is a link to the study,
https://www.ncbi.nlm.nih.gov/pubmed/27091875
and the Beacon also has an article that discusses it in some detail:
https://myelomabeacon.org/news/2016/04/19/myeloma-morning-empliciti-velcade-dexamethasone-treanda/
Also, cyclophosphamide often is used in heavily pretreated patients because some patients seem to respond to it. And, of course, cyclophosphamide often is combined with dexamethasone and bortezomib as either "VCD" or "CyBorD".
So there are several reasons your mother's doctors might want to pursue the regimen you described. The trick, of course, will be to administer the regimen in a way that is not too harsh for her (i.e., keep the side effects under control). Her doctors might choose, for example, to ramp up the dosage of the different medications, rather than give them at high doses right away. Or they may choose to give her medications to counteract potential side effects before they occur.
Good luck, and please keep us updated.
Re: Empliciti, Velcade, cyclophosphamide & dexamethasone
Velcade often causes neuropathy.. But it did work very well for me. Empliciti worked while I was getting weekly infusions, but seemed to lose potency when I moved to biweekly.
All the best to your mom.
All the best to your mom.
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Kebo - Name: Kebo
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 2008
- Age at diagnosis: 51
Re: Empliciti, Velcade, cyclophosphamide & dexamethasone
Update: This actually is working way better than expected. This regimen has cut my mother's light chain levels more than 50%.
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