Hi,
My father ( age 54, residing in India) was diagnosed with Stage 3 multiple myeloma 2 weeks back. It came as a bit of a shocker to us as all he suffered from was a sudden acute back pain. No anaemia, perfect kidney function, no Bence Jones protein, absolutely no other issues at all.. However, the PET CT scan showed a lot of his bones affected by lesions, specially D4 vertebra in the MRI reports, which began the cancer related investigations.
The doctor has right now put him on a 1-month treatment plan of Velcade, dexamethasone, and cyclophosphamide on Day 1, 8, 15, and 22 . Further treatment would be based on how his body responds to these drugs. He is broadly fine. He had developed a mild urinary tract infection on Day 2-3 and palpitations on Day 8, but otherwise he is quite fine, though a little weaker.
I have read about a lot of people being treated with Revlimid. Of the two, Velcade and Revlimid, which is the more effective one? And under what circumstances or conditions are the drugs given, as they don't seem to be interchangeably used.
He is also receiving radiations as a palliative measure, and has been given a pain relieving patch on his back.
We were planning for a mini vacation in the week he was diagnosed with cancer. It's weird at times what life has in store.
Thanks!
Forums
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Re: Velcade or Revlimid - which is more effective?
In the USA, a common initial treatment is Velcade, Revlimid and dexamethasone. So many people get both Velcade and Revlimid at the same time. After the initial treatment is over (5 months in my case, followed by a autologous stem cell transplant), many people are then put on Revlimid and dexamethasone as a maintenance treatment. Some people get Velcade as their maintenance drug. Also, there are several newer drugs that people are now taking, but I think they generally take those after Revlimid and/or Velcade stop working.
As to your question, I'm not sure which one is more effective. I'm guessing it might depend on what the genetic makeup of the multiple myeloma that a person has as to whether they get Revlimid or Velcade. Also, some people might have fewer side effects on one versus the other which might affect the decision on which one to take. Different countries have approved different drugs for upfront treatment and that also might affect the decision on which to take.
As to your question, I'm not sure which one is more effective. I'm guessing it might depend on what the genetic makeup of the multiple myeloma that a person has as to whether they get Revlimid or Velcade. Also, some people might have fewer side effects on one versus the other which might affect the decision on which one to take. Different countries have approved different drugs for upfront treatment and that also might affect the decision on which to take.
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DallasGG - Name: Kent
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: 6/20/2013
- Age at diagnosis: 56
Re: Velcade or Revlimid - which is more effective?
Hello Snahamundra,
Welcome to the forum but sorry your father does have stage 3 multiple myeloma. I hope that he does well with his treatments though. It is amazing sometimes as to how well the newer treatments can beat back the disease.
In Canada, with our public health care system which does give guidelines as to what drugs are given for initial therapy, it has been Velcade (bortezomib), cyclophosphamide, and dexamethasone until recently. Now, 'non-transplant eligible' patients may have Revlimid (lenalidomide) as an initial treatment. Both of these drugs can work well. Personally, I have taken both of the drugs, but not together, as a treatment. I am not sure what the situation would be in India. In my experience, both Revlimid and Velcade gave me side effects, but were effective against the myeloma. When I took Velcade for a few cycles, 8 years ago, it was given by IV. I got some mild neuropathy then. Now, it is given by a subcutaneous injection, which does not produce as much neuropathy.
Many patients opt to have an autologous stem cell transplant after their initial therapy. Maybe the doctor is going to discuss that with you also. Are you seeing a specialist who has a lot of myeloma patients? There has been so much research about this disease, and newer drugs coming on line all the time, that I think it is a good idea to learn as much as you can, and one's doctor should keep up to date on this also.
Best wishes, and keep us posted about his progress!
Welcome to the forum but sorry your father does have stage 3 multiple myeloma. I hope that he does well with his treatments though. It is amazing sometimes as to how well the newer treatments can beat back the disease.
In Canada, with our public health care system which does give guidelines as to what drugs are given for initial therapy, it has been Velcade (bortezomib), cyclophosphamide, and dexamethasone until recently. Now, 'non-transplant eligible' patients may have Revlimid (lenalidomide) as an initial treatment. Both of these drugs can work well. Personally, I have taken both of the drugs, but not together, as a treatment. I am not sure what the situation would be in India. In my experience, both Revlimid and Velcade gave me side effects, but were effective against the myeloma. When I took Velcade for a few cycles, 8 years ago, it was given by IV. I got some mild neuropathy then. Now, it is given by a subcutaneous injection, which does not produce as much neuropathy.
Many patients opt to have an autologous stem cell transplant after their initial therapy. Maybe the doctor is going to discuss that with you also. Are you seeing a specialist who has a lot of myeloma patients? There has been so much research about this disease, and newer drugs coming on line all the time, that I think it is a good idea to learn as much as you can, and one's doctor should keep up to date on this also.
Best wishes, and keep us posted about his progress!
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Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
Re: Velcade or Revlimid - which is more effective?
Hi Sneha,
My mother too got diagnosed with multiple myeloma in January this year in Mumbai. So like many other members of this forum I can relate to what you must be going through.
First things first: Don't worry too much about the staging, as I have seen and read on this forum that prognosis depends on how the patient responds to the treatment not the stage.
Coming to your question, I feel you should have asked about Revlimid vs. cyclophosphamide because reading about the triple combination drugs on this forum seems to have always included Velcade and dexamethasone. The only drug variable was Revlimid or cyclophosphamide. As a matter of fact, I too was was worried when my mother was put on Revlimid, Velcade, and dexamethasone (RVD) plus Zometa, because a couple of other doctors where of the opinion of starting Velcade, cyclophosphamide, and dex (VCD / CyBorD). Then our myeloma specialist told us that Velcade was the key drug and rest depends on the physicians, whether they go for cyclophosphamide or Revlimid. Both these have worked well so far.
Well, these were my two cents. Hope it helps.
My mother too got diagnosed with multiple myeloma in January this year in Mumbai. So like many other members of this forum I can relate to what you must be going through.
First things first: Don't worry too much about the staging, as I have seen and read on this forum that prognosis depends on how the patient responds to the treatment not the stage.
Coming to your question, I feel you should have asked about Revlimid vs. cyclophosphamide because reading about the triple combination drugs on this forum seems to have always included Velcade and dexamethasone. The only drug variable was Revlimid or cyclophosphamide. As a matter of fact, I too was was worried when my mother was put on Revlimid, Velcade, and dexamethasone (RVD) plus Zometa, because a couple of other doctors where of the opinion of starting Velcade, cyclophosphamide, and dex (VCD / CyBorD). Then our myeloma specialist told us that Velcade was the key drug and rest depends on the physicians, whether they go for cyclophosphamide or Revlimid. Both these have worked well so far.
Well, these were my two cents. Hope it helps.
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Tamo123mir - Name: Tam
- Who do you know with myeloma?: Mother
- When were you/they diagnosed?: Jan 2017
- Age at diagnosis: 57
Re: Velcade or Revlimid - which is more effective?
Hi snehamundra,
My mother is in India and she was diagnosed in 2011 after she had a pathological fracture in her right hand femur bone.
Since 2012 she is on Revlimid maintenance and never had a transplant. The doctor started with thalidomide, but that did not work in her case as her kappa-lambda free light chain ratio kept on increasing.
The doctor gave her 6 rounds of Velcade in 2012 due to a very high ratio and then in 2015 again she had a compression fracture in her vertebra and a high kappa-lambda ratio and she was again treated with 6 rounds of Velcade and dexamethasone along with radiation and Zometa (zoledronic acid).
So in her case Revlimid is used as maintenance therapy and Velcade is given to reduce her kappa-lambda ratio when it gets very high.
My mother is in India and she was diagnosed in 2011 after she had a pathological fracture in her right hand femur bone.
Since 2012 she is on Revlimid maintenance and never had a transplant. The doctor started with thalidomide, but that did not work in her case as her kappa-lambda free light chain ratio kept on increasing.
The doctor gave her 6 rounds of Velcade in 2012 due to a very high ratio and then in 2015 again she had a compression fracture in her vertebra and a high kappa-lambda ratio and she was again treated with 6 rounds of Velcade and dexamethasone along with radiation and Zometa (zoledronic acid).
So in her case Revlimid is used as maintenance therapy and Velcade is given to reduce her kappa-lambda ratio when it gets very high.
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