Can anyone direct me to a study or protocol for giving Velcade as conditioning during stem cell transplant (SCT) prep? I will get Velcade on Day -6 and -3, melphalan on Day -2, then Velcade again on Day 1 and 4.
This came about when I mentioned to my doctor a study I previously saw on the Beacon where they used Velcade for TP53 high-risk patients, but it was comparing giving ONE dose of Velcade either 24 hours before melphalan or 24 hours after.
Thanks.
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Studies / protocols for Velcade during transplant?
Last edited by heddleandhook on Wed Sep 23, 2015 1:35 am, edited 2 times in total.
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heddleandhook - Name: heddleandhook
- Who do you know with myeloma?: self
- When were you/they diagnosed?: Jan 2015
- Age at diagnosis: 68
Re: Studies / protocols for Velcade during transplant?
Ok, I'll answer my own question. ( just in case anyone might care.)
The doctor today gave me a copy of the study that outlines the protocol he is using for me.
http://www.bloodjournal.org/content/bloodjournal/115/1/32.full.pdf?sso-checked=true
The doctor today gave me a copy of the study that outlines the protocol he is using for me.
http://www.bloodjournal.org/content/bloodjournal/115/1/32.full.pdf?sso-checked=true
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heddleandhook - Name: heddleandhook
- Who do you know with myeloma?: self
- When were you/they diagnosed?: Jan 2015
- Age at diagnosis: 68
Re: Studies / protocols for Velcade during transplant?
Thanks for sharing the link to that study, H&H.
As you probably noticed, the study was done 5 or 6 years ago. At that point in time, induction therapy for newly diagnosed myeloma was not as long, and generally not as intense, as it is these days. So it's not clear you would see the same impact on response rates today if you ran the same study again.
Also, as far as I can see, the focus of the study is on the effect of the conditioning regimen on response rates. The real question, though, is whether the extra treatment with Velcade results in longer progression-free and (especially) overall survival. The authors didn't seem to look into that aspect of the issue when they did the comparisons with the control group used in the study.
As you're probably aware, a recent study looked at the question of whether extra treatment prior to transplantation, with the purpose of deepening response, affects PFS or OS, and found that it didn't make a difference:
https://myelomabeacon.org/news/2015/03/23/pre-transplant-depth-of-response-multiple-myeloma/
Myeloma specialists have been trying for years to come up with better "conditioning regimens" used during transplantation. My sense is that the results so far haven't been convincing enough to change how most transplant centres go about doing the conditioning prior to transplant. But, if you're interested in the subject, here is another article with more information on it:
https://myelomabeacon.org/news/2011/04/22/studies-aim-to-improve-transplantation-response-rates-in-multiple-myeloma-patients/
Cheers!
As you probably noticed, the study was done 5 or 6 years ago. At that point in time, induction therapy for newly diagnosed myeloma was not as long, and generally not as intense, as it is these days. So it's not clear you would see the same impact on response rates today if you ran the same study again.
Also, as far as I can see, the focus of the study is on the effect of the conditioning regimen on response rates. The real question, though, is whether the extra treatment with Velcade results in longer progression-free and (especially) overall survival. The authors didn't seem to look into that aspect of the issue when they did the comparisons with the control group used in the study.
As you're probably aware, a recent study looked at the question of whether extra treatment prior to transplantation, with the purpose of deepening response, affects PFS or OS, and found that it didn't make a difference:
https://myelomabeacon.org/news/2015/03/23/pre-transplant-depth-of-response-multiple-myeloma/
Myeloma specialists have been trying for years to come up with better "conditioning regimens" used during transplantation. My sense is that the results so far haven't been convincing enough to change how most transplant centres go about doing the conditioning prior to transplant. But, if you're interested in the subject, here is another article with more information on it:
https://myelomabeacon.org/news/2011/04/22/studies-aim-to-improve-transplantation-response-rates-in-multiple-myeloma-patients/
Cheers!
Re: Studies / protocols for Velcade during transplant?
Thank you Heddle: In your case, can you comment on the reason the extra Velcade is to be given. I gather that the trial you site is finished. Is the protocol off trial??
Thanks and regards, JPC
Thanks and regards, JPC
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JPC - Name: JPC
Re: Studies / protocols for Velcade during transplant?
Thanks Ian for the links. I haven't had time to read them yet, but will get to them soon.
JPC - The reason is basically because I have high risk TP53 deletion and monosomy 13, and then on flow cytometry it was found I have plasma cells in the peripheral blood. The doctor especially likes that this protocol has me getting the Velcade on Day 1 and because of those peripheral cells.
The plan is also that I will have Velcade for maintenance, as that has been shown to be best for patients with 17p deletion. Also they want to make this SCT count, as I will never get another, either auto or allo.
JPC - The reason is basically because I have high risk TP53 deletion and monosomy 13, and then on flow cytometry it was found I have plasma cells in the peripheral blood. The doctor especially likes that this protocol has me getting the Velcade on Day 1 and because of those peripheral cells.
The plan is also that I will have Velcade for maintenance, as that has been shown to be best for patients with 17p deletion. Also they want to make this SCT count, as I will never get another, either auto or allo.
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heddleandhook - Name: heddleandhook
- Who do you know with myeloma?: self
- When were you/they diagnosed?: Jan 2015
- Age at diagnosis: 68
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