I read a comment on the latest post in "Opinion" where the writer says that "all the literature shows that Revlimid, as maintenance, after ASCT doubles PFS and OS"
Is that correct?
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Snip - Name: John Snippe
- Who do you know with myeloma?: me
- When were you/they diagnosed?: Jan, 2011
- Age at diagnosis: 56
Re: Revlimid maintenance doubles life expectancies?
Hi Snip,
The Beacon had an article about 3 recent studies. Two showed no Overall Survival benefit and one showed a slight OS benefit. It does show a PFS benefit but comes at the cost of decreased quality of life. I do not use maintenance.
https://myelomabeacon.org/news/2012/05/11/revlimid-lenalidomide-maintenance-therapy-studies-clarify-benefits-and-risks/
Mark
The Beacon had an article about 3 recent studies. Two showed no Overall Survival benefit and one showed a slight OS benefit. It does show a PFS benefit but comes at the cost of decreased quality of life. I do not use maintenance.
https://myelomabeacon.org/news/2012/05/11/revlimid-lenalidomide-maintenance-therapy-studies-clarify-benefits-and-risks/
Mark
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Anonymous
Re: Revlimid maintenance doubles life expectancies?
Hi Snip and Mark,
Mark posted the link to the MB article just as I was about to do it. I'll add here, however, the summary from the article, since it's useful:
“All three trials found that Revlimid maintenance therapy significantly delays the progression of multiple myeloma. In younger newly diagnosed myeloma patients who had undergone a stem cell transplant, for example, Revlimid maintenance therapy nearly doubled the time to relapse.”
“Only one of the three trials, however, found that Revlimid maintenance therapy improved the overall survival of patients. In the other two trials, patients who were on Revlimid maintenance therapy typically lived no longer than those who took the placebo.”
“In addition, all three trials revealed that the patients taking Revlimid were significantly more likely to experience a second cancer than those who took a placebo.”
(I also put the link and this summary in the comments on Kevin's latest column.)
Mark posted the link to the MB article just as I was about to do it. I'll add here, however, the summary from the article, since it's useful:
“All three trials found that Revlimid maintenance therapy significantly delays the progression of multiple myeloma. In younger newly diagnosed myeloma patients who had undergone a stem cell transplant, for example, Revlimid maintenance therapy nearly doubled the time to relapse.”
“Only one of the three trials, however, found that Revlimid maintenance therapy improved the overall survival of patients. In the other two trials, patients who were on Revlimid maintenance therapy typically lived no longer than those who took the placebo.”
“In addition, all three trials revealed that the patients taking Revlimid were significantly more likely to experience a second cancer than those who took a placebo.”
(I also put the link and this summary in the comments on Kevin's latest column.)
Re: Revlimid maintenance doubles life expectancies?
Thanks, guys!
I am 16 months post-ASCT, and my onc and I agreed to not to any further therapy for now (I have a "very good partial" response, and so far the numbers have stayed stable) The thinking at the time was that there just wasn't sufficient justification for Revlimid ongoing, and then I read that article I referenced. Needless to say I was "WHAT!?!?" Good to know I am on the right side of that equation
I am 16 months post-ASCT, and my onc and I agreed to not to any further therapy for now (I have a "very good partial" response, and so far the numbers have stayed stable) The thinking at the time was that there just wasn't sufficient justification for Revlimid ongoing, and then I read that article I referenced. Needless to say I was "WHAT!?!?" Good to know I am on the right side of that equation
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Snip - Name: John Snippe
- Who do you know with myeloma?: me
- When were you/they diagnosed?: Jan, 2011
- Age at diagnosis: 56
Re: Revlimid maintenance doubles life expectancies?
The statistics can be so misleading and I guess we can all read and interpret how we want and that interpretation may change from day to day.
As everyone is different and will have a different result as far as I can see there is no real way of proving/showing that taking Revlimid or any other drus as maintenance can make a different.
I had my tandem in Dec 2011/March 2012 and started maintenance of Kyprolis in Aug 2012 and have just relapsed. Would the outcome be different if I added Revlimid and started maintenance sooner. We will never know and the stats only compare a randomized group of people - the level, type and history of their myeloma will always be different so really we are comparing different types of apples as opposeds to Washington reds of the smae size, weight and growth conditions.
Sometimes it all makes sense to me and then sometimes I am totally confused with no direction.
Michelle Gillet
South Florida
aged 43.
As everyone is different and will have a different result as far as I can see there is no real way of proving/showing that taking Revlimid or any other drus as maintenance can make a different.
I had my tandem in Dec 2011/March 2012 and started maintenance of Kyprolis in Aug 2012 and have just relapsed. Would the outcome be different if I added Revlimid and started maintenance sooner. We will never know and the stats only compare a randomized group of people - the level, type and history of their myeloma will always be different so really we are comparing different types of apples as opposeds to Washington reds of the smae size, weight and growth conditions.
Sometimes it all makes sense to me and then sometimes I am totally confused with no direction.
Michelle Gillet
South Florida
aged 43.
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meeshymeesh - Name: Michelle
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 2009
- Age at diagnosis: 40
Re: Revlimid maintenance doubles life expectancies?
meeshymeesh wrote:
> The statistics can be so misleading and I guess we can all read and
> interpret how we want and that interpretation may change from day to day.
Although there is truth to that, I would suggest that the folks tasked with doing the statistics are more scientifically rigorous than that... so that over time and as we get more data those statistics become meaningful.
> The statistics can be so misleading and I guess we can all read and
> interpret how we want and that interpretation may change from day to day.
Although there is truth to that, I would suggest that the folks tasked with doing the statistics are more scientifically rigorous than that... so that over time and as we get more data those statistics become meaningful.
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Snip - Name: John Snippe
- Who do you know with myeloma?: me
- When were you/they diagnosed?: Jan, 2011
- Age at diagnosis: 56
Re: Revlimid maintenance doubles life expectancies?
John,
My husband was diagnosed two years ago and underwent a stem cell transfusion. He takes medicine daily including Revlimid, has blood transfusions and undergoes cymotherapy (orally) He sees his doctor every six months.
When he was first diagnosed he lost 25 pounds but has regained it and is eating normally. He plays golf 5x a week and tennis 2x a week.
As he's on Revlimid is his life expectancy twice as long as to what I have heard?
Debbie
My husband was diagnosed two years ago and underwent a stem cell transfusion. He takes medicine daily including Revlimid, has blood transfusions and undergoes cymotherapy (orally) He sees his doctor every six months.
When he was first diagnosed he lost 25 pounds but has regained it and is eating normally. He plays golf 5x a week and tennis 2x a week.
As he's on Revlimid is his life expectancy twice as long as to what I have heard?
Debbie
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Debbie Stewart
Re: Revlimid maintenance doubles life expectancies?
My reading of the data is that while one study did show a statistically significant improved overall survival rate with Revlimid maintenance, the differences with placebo are not large, and is essentially the same. So, I think that all three groups, when you look at the big picture, shows that while Rev-maintenance may lengthen the duration of remission, it does not improve overall survival in any meaningful way.
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dnalex - Name: Alex N.
- Who do you know with myeloma?: mother
- When were you/they diagnosed?: 2007
- Age at diagnosis: 56
Re: Revlimid maintenance doubles life expectancies?
I am not a a point where I need to make a decision about maintenance. My doc is recommending 10 mg of Revlimid daily. Besides the enormous cost,( $100,000 per year and not sure that Medicare plus Medicap will cover), I am not clear that it has much benefit. I have seen other posts about different approaches to maintenance including someone who says they take on 25 mg Revlimid weekly with Dex. Others talk about Velcade every month or two. I would really like to know what all the different maintenance options are.
I am further confused or enlightened when reading about how long term survival is a function of the quality of the immune system. ( See today's headline article). Seems to me you want to enhance the immune system as much as possible and keep the amount of CHEMO drugs to a minimum to minimize drug resistance but still keep the multiple myeloma under control . So taking something every day that also lowers white blood cells may not be the optimum solution. I think more research into maintenance options needs to be done. The people who post and are active with their exercise seem to do really well. I would like to hear more from people to have decided against maintenance, or have minimal maintenance protocols.
Paul Jorgensen
Annapolis Maryland
I am further confused or enlightened when reading about how long term survival is a function of the quality of the immune system. ( See today's headline article). Seems to me you want to enhance the immune system as much as possible and keep the amount of CHEMO drugs to a minimum to minimize drug resistance but still keep the multiple myeloma under control . So taking something every day that also lowers white blood cells may not be the optimum solution. I think more research into maintenance options needs to be done. The people who post and are active with their exercise seem to do really well. I would like to hear more from people to have decided against maintenance, or have minimal maintenance protocols.
Paul JorgensenAnnapolis Maryland
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Pjorg45 - Name: Paul Jorgensen
- When were you/they diagnosed?: May 1013
- Age at diagnosis: 68
Re: Revlimid maintenance doubles life expectancies?
In addition to the link Mark (Anonymous) posted about Revlimid maintenance therapy above, the Beacon also has published two other articles readers may wish to consult about the subject.
One is an update on Revlimid maintenance therapy covering presentations given at the International Myeloma Workshop this past spring.
The other is a column by Dr. David Vesole which the Beacon published last year titled "To Maintain Or Not To Maintain - That Is The Question!".
All the Beacon's news and opinion articles on maintenance therapy can be found by following this link.
One is an update on Revlimid maintenance therapy covering presentations given at the International Myeloma Workshop this past spring.
The other is a column by Dr. David Vesole which the Beacon published last year titled "To Maintain Or Not To Maintain - That Is The Question!".
All the Beacon's news and opinion articles on maintenance therapy can be found by following this link.
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