New to this so please bear with me. My husband (60) was diagnosed in January and had a great response to B/D. We went to our specialist yesterday expecting to hear that we would go on maintenance however, his IgG and Kappa had both risen so Doc is suggesting new therapy. He is encouraging a clinical trial of C/D at a different dose than the current FDA approval. My husband was the last patient included in this study so this is happening really quickly...biopsy, etc to be done next week and our regular oncologist is on vacation!
After perusing this forum, I've only found people on C/R/D. Any help/feedback will be greatly appreciated!
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Susang - Name: Susang
- Who do you know with myeloma?: Phil/Husband
- When were you/they diagnosed?: Jan 5 2013
- Age at diagnosis: 60
Re: Kyprolis/Dex after Velcade
Has your husband received treatment with anything other than Velcade and dex? For example, has he had a stem cell transplant, or been treated with Revlimid or thalidomide?
Re: Kyprolis/Dex after Velcade
TerryH: No, we were considering harvesting for a sct, but wanted to hold out since he was doing so well. The doctor really "sold" this trial to my husband, but I am not convinced. I think maybe trying Rev would be a better option. Thanks!
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Susang - Name: Susang
- Who do you know with myeloma?: Phil/Husband
- When were you/they diagnosed?: Jan 5 2013
- Age at diagnosis: 60
Re: Kyprolis/Dex after Velcade
Your husband relapsed pretty quickly after his Velcade-dexamethasone treatment, which suggests that his myeloma may be relatively aggressive.
I don't know how many cycles of Vel-dex your husband had. I also don't know whether he achieved a complete response or not.
But he didn't have many cycles, one option might be to re-start treatment with Vel-dex, combining it with either Revlimid or Cytoxan. I can't say, however, whether that's something physicians normally consider. It may not be; I'm just throwing out some things to consider (and have others react to).
If your husband had a reasonable number of Vel-dex cycles -- say, more than three or four -- then it's probably best to consider treatment with something else, and also probably something that will be a bit more intensive than just two agents.
So I'm not sure that Revlimid + dexamethasone would be the best option here. Nor, however, do I think Kyprolis + dexamethasone would be a great option, given that Kyprolis is in the same class of drugs as Velcade.
My suggestion would be to look at three (or four) drug combinations involving Revlimid and other things. Kyprolis, Revlimid, and dex would be one option. Another option might be Revlimid, dex, and Biaxin, although it probably won't be as effective as the Kyproils-Revlimid-dex combination.
There's also this trial of Revlimid, Kyprolis, Zolinza, and dex in relapsed myeloma patients:
http://clinicaltrials.gov/ct2/show/NCT01297764
which I think your husband would be eligible for. The trial is based in New Jersey.
You may want to check http://www.clinicaltrials.gov in general to see what sort of trials are available to your husband.
I don't know how many cycles of Vel-dex your husband had. I also don't know whether he achieved a complete response or not.
But he didn't have many cycles, one option might be to re-start treatment with Vel-dex, combining it with either Revlimid or Cytoxan. I can't say, however, whether that's something physicians normally consider. It may not be; I'm just throwing out some things to consider (and have others react to).
If your husband had a reasonable number of Vel-dex cycles -- say, more than three or four -- then it's probably best to consider treatment with something else, and also probably something that will be a bit more intensive than just two agents.
So I'm not sure that Revlimid + dexamethasone would be the best option here. Nor, however, do I think Kyprolis + dexamethasone would be a great option, given that Kyprolis is in the same class of drugs as Velcade.
My suggestion would be to look at three (or four) drug combinations involving Revlimid and other things. Kyprolis, Revlimid, and dex would be one option. Another option might be Revlimid, dex, and Biaxin, although it probably won't be as effective as the Kyproils-Revlimid-dex combination.
There's also this trial of Revlimid, Kyprolis, Zolinza, and dex in relapsed myeloma patients:
http://clinicaltrials.gov/ct2/show/NCT01297764
which I think your husband would be eligible for. The trial is based in New Jersey.
You may want to check http://www.clinicaltrials.gov in general to see what sort of trials are available to your husband.
Re: Kyprolis/Dex after Velcade
Thanks so much for your input. He JUST completed his 8th cycle of Velcade at the end of July and all the numbers had been going in the right direction, so we were shocked at this news. I will check out the links you suggested. Again, thanks !
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Susang - Name: Susang
- Who do you know with myeloma?: Phil/Husband
- When were you/they diagnosed?: Jan 5 2013
- Age at diagnosis: 60
Re: Kyprolis/Dex after Velcade
VRD is a very strong combination and has been shown to be better than VD or RD by themselves. It appears that Revlimid when combined with Velcade work better together enhancing the effects of each other. They attack the myeloma in different ways and makes it more difficult for the disease to resist. So I think adding Revlimid to the mix is worth at least having a discussion with your oncologist. Kyprolis is in the same category or class of drugs as Velcade so I am not so sure that merely replacing one with the other will be the answer but that again is something for experts to explain to you.
Ron
Ron
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Ron Harvot - Name: Ron Harvot
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: Feb 2009
- Age at diagnosis: 56
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