[Snoodle]

Pomalyst with Velcade

by Snoodle on Sat Mar 23, 2013 10:26 am

Hello,

After three cycles of Kyprolis (which did not work so well), my husband is starting Pomalyst and Velcade. I can find a few references to that combination on the web--but very few. Seems like there have been more studies with Kyprolis and Pomalyst. What's interesting is that the clinical study I found uses a 21-day cycle (14 on and 7 days off), which I haven't really seen referenced before. My husband was prescribed a 28-day cycle. I ask him to bring up the idea of a 14-day cycle or ask for some reference to the 28-day cycle. The response was basically "28-day cycles are standard; your wife must have misread something."

So my question is: is anyone taking Pomalyst and Velcade? What's your dosing schedule? And how are the side effects?

Thanks,
S

[TerryH]

Re: Pomalyst with Velcade

by TerryH on Sat Mar 23, 2013 11:56 am

Hi Snoodle,

I hope your husband responds well to the Pomalyst-Velcade-dexamethasone (PVD) regimen.

There have been different dosing regimens used with the PVD regimen.

A Phase 1/2 trial by the Mayo Clinic is using a 28-day cycle. You can find more information about it here:

http://clinicaltrials.gov/ct2/show/NCT01212952

Two other trials, however, are using 21-day cycles. This Phase 1 trial,

http://clinicaltrials.gov/ct2/show/NCT01497093

for which initial results were presented at the ASH meeting this past December; see the writeup and slides here:

https://myelomabeacon.org/news/2012/12/11/ash-2012-multiple-myeloma-update-day-three-late-afternoon-oral-session/

Also, this Phase 3 clinical trial is also using a 21-day cycle

http://clinicaltrials.gov/ct2/show/NCT01734928

Note that, just as the cycle length is different between the trials, so is how often Velcade is given. In the trials with a 21-day cycle, Velcade is given twice a week for two weeks, with a week off. In the 28-day cycle trial, Velcade is given once a week essentially throughout the treatment.

If your husband has issues with peripheral neuropathy, then a less frequent dosing schedule may be more desirable. Also, it probably is a good idea to ask about having the Velcade given as an under-the-skin (subcutaneous) injection, rather than by infusion, unless your husband's doctor has specific reasons he/she feels your husband should receive the Velcade by infusion. (Subcutaneous Velcade also generally has lower peripheral neuropathy than infused Velcade.)