Forums
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Paul J - Name: Paul J
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: January 2012
- Age at diagnosis: 55
Re: Should I start back on Revlimid maintenance therapy?
Coach Hoke,
Congrats on the good news! You know what I think - keep enjoying the improved quality of life that comes with a drug free remission!
If you saw the results of the FIRST trial, the overall survival stat that was reported for patients who were on never ending cycles of Revlimid / dex was basically the same as the overall survival stat for patients that did 18 cycles of Revlimid / dex and than stopped.
Source: L Benboubker et al., "Lenalidomide and Dexamethasone in Transplant-Ineligible Patients with Myeloma," New England Journal of Medicine, Sep 4, 2014 (full text of article).
I would take improved quality of life over that small chance of being alive at 4 years.
Mark
Congrats on the good news! You know what I think - keep enjoying the improved quality of life that comes with a drug free remission!
If you saw the results of the FIRST trial, the overall survival stat that was reported for patients who were on never ending cycles of Revlimid / dex was basically the same as the overall survival stat for patients that did 18 cycles of Revlimid / dex and than stopped.
"Overall survival at 4 years was 59% with continuous lenalidomide-dexamethasone, 56% with 18 cycles of lenalidomide-dexamethasone, and 51% with MPT."
Source: L Benboubker et al., "Lenalidomide and Dexamethasone in Transplant-Ineligible Patients with Myeloma," New England Journal of Medicine, Sep 4, 2014 (full text of article).
I would take improved quality of life over that small chance of being alive at 4 years.
Mark
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Mark11
Re: Should I start back on Revlimid maintenance therapy?
The study you cite is based on transplant ineligible, median age = 73 +, patients, etc.
I think Doc is / was transplant eligible. I could be wrong.
I suggest that study is somewhat inapplicable to most of the folks here. Also, it is interesting to note that it also cites long term lenalidomide users, have the lowest risk of secondary cancer development -- as compared to the other two categories ( 2 Yr lenalidomide users; melphalan, etc. users).
Regardless -- Doc, congrats on your good health.
I think Doc is / was transplant eligible. I could be wrong.
I suggest that study is somewhat inapplicable to most of the folks here. Also, it is interesting to note that it also cites long term lenalidomide users, have the lowest risk of secondary cancer development -- as compared to the other two categories ( 2 Yr lenalidomide users; melphalan, etc. users).
Regardless -- Doc, congrats on your good health.
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Rneb
Re: Should I start back on Revlimid maintenance therapy?
Rneb,
In general, transplant-ineligible protocols are generally just "gentler" and may (but not necessarily) utilize agents that can complicate transplant suitability down the road. However, just because a study is targeted at transplant ineligible patients doesn't automatically make it inapplicable to transplant eligible patients.
See comments from Dr. Hoffman:
"Transplant refusal & myeloma treatment protocols" (forum disc. started Sep 23, 2014)
In general, transplant-ineligible protocols are generally just "gentler" and may (but not necessarily) utilize agents that can complicate transplant suitability down the road. However, just because a study is targeted at transplant ineligible patients doesn't automatically make it inapplicable to transplant eligible patients.
See comments from Dr. Hoffman:
"Transplant refusal & myeloma treatment protocols" (forum disc. started Sep 23, 2014)
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Should I start back on Revlimid maintenance therapy?
Rneb,
You are right; I was (am) transplant eligible, but chose not to take that route. I also chose to stop the Revlimid maintenance after two years despite Palumbo's and some other studies that seem to show overall longer survival if you stay on it forever.
Revlimid seemed to work pretty well for me, so when I relapse I'll try it again.
Coach Hoke
You are right; I was (am) transplant eligible, but chose not to take that route. I also chose to stop the Revlimid maintenance after two years despite Palumbo's and some other studies that seem to show overall longer survival if you stay on it forever.
Revlimid seemed to work pretty well for me, so when I relapse I'll try it again.
Coach Hoke
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coachhoke - Name: coachhoke
- When were you/they diagnosed?: Apri 2012
- Age at diagnosis: 71
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