This poll question is one of four that we are running for several weeks, asking Beacon readers how many cycles of treatment they had with different initial treatment regimens.
This specific poll question should be answered by readers who were treated with the three-drug combination of Revlimid, Velcade, and dexamethasone (RVD, VRD) as their initial (induction) therapy after being diagnosed with multiple myeloma.
The other three polls being conducted right now are similar, but are for readers whose initial treatment regimen was either Revlimid-dexamethasone (Rd, RD), Velcade-dexamethasone (Vd), or Velcade-cyclosphosphamide (Cytoxan)-dexamethasone (VCD, CyBorD).
A few clarifications:
First, please answer this poll question only if your initial therapy after diagnosis included only Revlimid, Velcade, and dex as anti-myeloma agents. If your regimen also included one or more drugs in addition to Revlimid, Velcade, and dex, we're afraid that we don't have a poll question for you at this time.
Note that, for the purpose of this poll, we are not counting bisphosphonates, such as Aredia (pamidronate) and Zometa (zoledronic acid), as "anti-myeloma therapies". Thus, you are still welcome to answer this poll question if, for example, you were put on a regimen of Revlimid, Velcade, and dex plus regular Zometa infusions after your initial diagnosis.
Second, this question is about your initial (induction) therapy after diagnosis. Please do not answer the question if you received Revlimid, Velcade, and dex as treatment after relapse, or as maintenance therapy after a stem cell transplant.
Third, if you are a caregiver or family member of a multiple myeloma patient, feel free to answer on their behalf.
Fourth, we realize that the length of a cycle of treatment sometimes can vary from patient to patient. Sometimes the cycle is 21 days. Sometimes it is 28 days. Other times it is longer. For your answer, please use whatever cycle length applied in your specific case.
Fifth, if you have the time, please post as a comment on the poll why you received as many cycles of Revlimid-Velcade-dex as you did.
For example, was the number of cycles you received set in advance -- that is, did you and your doctors decide ahead of time that you would receive, say, four cycles of the regimen? Or was the number of cycles determined by how you responded to the treatment, or perhaps by the side effects you experienced?
These comments will be very helpful to other Beacon readers.
As always, we appreciate your responding to the Beacon's poll questions. The polls are another way that The Beacon seeks to provide valuable information and support to its readers, so your participation in the polls helps us in this important effort.
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Re: Weekly Poll - Cycles Of Initial Therapy - RVD/VRD - 2014
Initial plans were for 4 rounds of treatments, two weeks on one week off. I ended up doing 5 rounds and start the bone marrow transplant process this coming Friday.
From my bone marrow results, I had excellent response to the treatments. I have some pretty severe pain from some of the lesions in my hip and pelvis area.
I'm looking forward to getting this BMT completed. I'm doing auto -- no donor needed. I hope my body produces enough cells for the transplant.
From my bone marrow results, I had excellent response to the treatments. I have some pretty severe pain from some of the lesions in my hip and pelvis area.
I'm looking forward to getting this BMT completed. I'm doing auto -- no donor needed. I hope my body produces enough cells for the transplant.
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medic944 - Name: Clayton Bronson
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: December 2013
- Age at diagnosis: 52
Re: Weekly Poll - Cycles Of Initial Therapy - RVD/VRD - 2014
My husband is on his 6th cycle of Revlimid, dexamethasone, and Velcade and, after that, he is supposed to be on just Revlimid for maintenance.
Last urine test showed his lambda light chain went down from 844 to 40. He's been off dialysis now about a month. He's still anemic, wbc is about 6, he can't seem to gain weight (he weighed about 185 pounds prior to this, now he's 145, and his lowest was 135).
He was diagnosed Stage 3 with 5 bone lesion, 31% malignancy. Probably will do a bone marrow biopsy soon to see what that % is at now after his 6 cycles. If % isn't good, I guess he's looking at bone marrow transplant. Don't know much about that.
He's 64 white male and was very healthy and active.
This is my very first post. I'm so lost in this world called cancer.
Last urine test showed his lambda light chain went down from 844 to 40. He's been off dialysis now about a month. He's still anemic, wbc is about 6, he can't seem to gain weight (he weighed about 185 pounds prior to this, now he's 145, and his lowest was 135).
He was diagnosed Stage 3 with 5 bone lesion, 31% malignancy. Probably will do a bone marrow biopsy soon to see what that % is at now after his 6 cycles. If % isn't good, I guess he's looking at bone marrow transplant. Don't know much about that.
He's 64 white male and was very healthy and active.
This is my very first post. I'm so lost in this world called cancer.
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Mchelle1221
Re: Weekly Poll - Cycles Of Initial Therapy - RVD/VRD - 2014
I have responded to this post, but I am unclear as to its purpose.
Is it to understand which therapy is best, post- stem cell transplant?
Or to confirm how long you should remain on this regime (give guidance to others?).
Or to understand how many cycles one should expect?
Without knowing about the individual's medical history, what is the point or idea behind this?
Thanks.
Is it to understand which therapy is best, post- stem cell transplant?
Or to confirm how long you should remain on this regime (give guidance to others?).
Or to understand how many cycles one should expect?
Without knowing about the individual's medical history, what is the point or idea behind this?
Thanks.
Re: Weekly Poll - Cycles Of Initial Therapy - RVD/VRD - 2014
Thanks for your questions, Mark.
We are conducting this set of polls in response to questions that have come up regularly here in the forum. Those questions have inquired as to how long others here in the forum have been treated with a specific treatment regimen after they were diagnosed.
By conducting the current set of polls -- which focus on four of the most commonly used initial treatment regimens -- we hope to provide our readers with more extensive data about what is the "typical" length of treatment for certain regimens.
We recognize that how long individual patients are treated with a specific regimen will depend on a range of different factors, including the specifics of the patient's disease and the preferences of the patient's physician / treatment center.
We suspect, however, that many readers being treated with RVD/VRD as their first-line therapy will find it useful -- for example -- to know that some 70 percent of other patients treated with the regimen were given the regimen for either 4 or 5 cycles (based on the current results of the poll).
Please note, as well, that this poll -- and the others currently being run in parallel -- ask about the length of treatment when the regimen is being used as the patient's initial therapy, right after diagnosis. Your question, which mentions treatment "post-stem cell transplant", suggested you thought the poll was about the length of treatment anytime the regimen might be used.
Your question also seems to assume that length of treatment is routinely dependent on the patient's response to treatment. If you review the results of the polls thus far, you'll note that this does not seem to be the case -- that certain treatment lengths are particularly common.
Given that patients do, in fact, respond differently to treatment regimens, this result suggests that there are "standard" treatment lengths that are used regardless of a patient's response to treatment.
That finding, we believe, is one of the valuable results of these polls.
(We're not suggesting, by the way, that a "one treatment length fits all" approach to therapy is optimal. What we are saying is that the poll results thus far indicate that, for several of the treatment regimens, this seems to be a common approach.)
We are conducting this set of polls in response to questions that have come up regularly here in the forum. Those questions have inquired as to how long others here in the forum have been treated with a specific treatment regimen after they were diagnosed.
By conducting the current set of polls -- which focus on four of the most commonly used initial treatment regimens -- we hope to provide our readers with more extensive data about what is the "typical" length of treatment for certain regimens.
We recognize that how long individual patients are treated with a specific regimen will depend on a range of different factors, including the specifics of the patient's disease and the preferences of the patient's physician / treatment center.
We suspect, however, that many readers being treated with RVD/VRD as their first-line therapy will find it useful -- for example -- to know that some 70 percent of other patients treated with the regimen were given the regimen for either 4 or 5 cycles (based on the current results of the poll).
Please note, as well, that this poll -- and the others currently being run in parallel -- ask about the length of treatment when the regimen is being used as the patient's initial therapy, right after diagnosis. Your question, which mentions treatment "post-stem cell transplant", suggested you thought the poll was about the length of treatment anytime the regimen might be used.
Your question also seems to assume that length of treatment is routinely dependent on the patient's response to treatment. If you review the results of the polls thus far, you'll note that this does not seem to be the case -- that certain treatment lengths are particularly common.
Given that patients do, in fact, respond differently to treatment regimens, this result suggests that there are "standard" treatment lengths that are used regardless of a patient's response to treatment.
That finding, we believe, is one of the valuable results of these polls.
(We're not suggesting, by the way, that a "one treatment length fits all" approach to therapy is optimal. What we are saying is that the poll results thus far indicate that, for several of the treatment regimens, this seems to be a common approach.)
Re: Weekly Poll - Cycles Of Initial Therapy - RVD/VRD - 2014
At my initial consultation the plan laid out was 4-6 cycles to be followed by a stem cell transplant. I was ready for the transplant after 4 cycles but because of other "life" commitments I wanted to delay the transplant. So we continued the VRD regimen for two additional cycles followed by a month off before stem cell collection and transplant.
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goldmine848 - Name: Andrew
- When were you/they diagnosed?: June 2013
- Age at diagnosis: 60
Re: Weekly Poll - Cycles Of Initial Therapy - RVD/VRD - 2014
Is VRD generally used as an upfront regiment for more aggressive myleoma vs just Vd or Rd? Sorry still trying to figure out stuff...we don't see our doctor much-just the nurses.
Re: Weekly Poll - Cycles Of Initial Therapy - RVD/VRD - 2014
Hopeful,
There isn't a simple, clear cut answer to this question.
In fact, there are trials going on to help better answer this question (i.e. is it overkill to put a patient on VRd, or would the patient be better served to be started out on just Vd and then escalate to VRd, if needed?). More drugs = more toxicity , potential secondary cancers, greater risk for PN and potentially lower QOL, so it's a good question to be answering.
And then you get into the entire discussion of whether it is better to try be ultra aggressive with front line chemo treatment (and going for broke for a deeper, upfront response) versus saving some of your drug choices for a later day when you relapse or become refractory...or finding some sort of a balance between these two approaches? It's not an easy question to answer.
And then there is the question of whether VRd is even the best combo to use versus some other combo, whether it be a doublet, triplet or quadruplet cocktail?
You also have other issues such as age, kidney health, etc to factor into the equation regarding the selection of drugs themselves. As an example, drugs like Revlimid are to be avoided or reduced in dosage if renal dysfunction is present.
This is why it is good to get second opinions and to question the specialists on their recommendations. You will get different answers depending on who you talk to.
Note that the Mayo recommends VRd as the front line treatment for high-risk NDMM patients, but this doesn't mean that this is an industry-wide recommendation that is followed by all institutions and specialists.
I don't mean to make things more confusing for you. I'm just trying to convey that it pays to talk to multiple specialists as you start to formulate your own philosophy for treatment.
There isn't a simple, clear cut answer to this question.
In fact, there are trials going on to help better answer this question (i.e. is it overkill to put a patient on VRd, or would the patient be better served to be started out on just Vd and then escalate to VRd, if needed?). More drugs = more toxicity , potential secondary cancers, greater risk for PN and potentially lower QOL, so it's a good question to be answering.
And then you get into the entire discussion of whether it is better to try be ultra aggressive with front line chemo treatment (and going for broke for a deeper, upfront response) versus saving some of your drug choices for a later day when you relapse or become refractory...or finding some sort of a balance between these two approaches? It's not an easy question to answer.
And then there is the question of whether VRd is even the best combo to use versus some other combo, whether it be a doublet, triplet or quadruplet cocktail?
You also have other issues such as age, kidney health, etc to factor into the equation regarding the selection of drugs themselves. As an example, drugs like Revlimid are to be avoided or reduced in dosage if renal dysfunction is present.
This is why it is good to get second opinions and to question the specialists on their recommendations. You will get different answers depending on who you talk to.
Note that the Mayo recommends VRd as the front line treatment for high-risk NDMM patients, but this doesn't mean that this is an industry-wide recommendation that is followed by all institutions and specialists.
I don't mean to make things more confusing for you. I'm just trying to convey that it pays to talk to multiple specialists as you start to formulate your own philosophy for treatment.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
9 posts
• Page 1 of 1