[tpt]

Standard time for myeloma treatment response evaluation?

by tpt on Thu Jul 26, 2018 4:36 am

Hi,

It's my understanding that the definition of a very good partial response (VGPR) is a more than 90% reduction in serum monoclonal protein and a monoclonal protein level in the urine of less than 100 mg/24 hours.

My question is, what is the length of the treatment for the response evaluation?

I am trying to put this into my personal experience.

My kappa myeloma relapsed (biochemically) about two months ago. The number was 143 mg/L. After 1 cycle of Revlimid plus dexamethasone (RD), it came down to 43 mg/L. After another cycle of RD, it went down to 25 mg/L. This means that by definition I have not yet achieved a VGPR.

Or, perhaps, this treatment is soon to be evaluated? After how many cycles will its response be evaluated?

Another example: On my initial diagnosis, my kappa free light chain level was in the range of 700 mg/L, and after 3 cycles of Velcade, thalidomide, and dexamethasone (VTD), the number went down into the 100 mg/L range. After 7 additional cycles, the number came down to 60 mg/L ish, before proceeding to stem cell harvest. Does this mean that I achieved VGPR on this 10-cycle treatment?

Thanks!

[Cheryl G]

Re: Standard time for myeloma treatment response evaluation?

by Cheryl G on Thu Jul 26, 2018 3:43 pm

Hi tpt,

Any time a patient gets their myeloma-related results reported during treatment, a treatment response classification can be made.

Thus, a newly diagnosed patient typically will go from an initial response to treatment is not very deep, to a partial response (PR), and then to deeper responses, such as a very good partial response (VGPR), a complete response (CR), and even a stringent complete response (sCR).

A response classification can be made every time the patient's M-spike and/or free light chain levels are measured, since they can be compared to the M-spike and/or free light chain levels at diagnosis to determine the response.

So there's no "standard time" to measure response; it's measured throughout the time on treatment.