[Beacon Staff]

Weekly Poll - Initial Myeloma Therapy - 2012

by Beacon Staff on Wed Apr 04, 2012 10:01 am

This week’s poll is about what your initial myeloma therapy was upon your diagnosis.

A few clarifications:

First, please answer this poll only if you have been diagnosed with multiple myeloma within the last two years.

Second, initial therapy is frequently called induction therapy. It does not matter for this question whether you proceeded to have a stem cell transplant after the initial therapy.

Third, if you are a caregiver or family member of a myeloma patient, feel free to answer on their behalf.

Fourth, if you received a therapy that is not included in the list above, please use the space below to describe it.

As always, feel free to post comments, thoughts, or feedback in the space below. They can be very useful to other readers.

[David Cook]

Re: Weekly Poll - Initial Myeloma Therapy

by David Cook on Wed Apr 04, 2012 2:05 pm

I put other as my wife's therapy was Cyclophosphamide, Thalidomide, and Dexamethasone (CTD), which is often the initial myeloma therapy here in England prior to a stem cell transplant.

[suzierose]

Re: Weekly Poll - Initial Myeloma Therapy

by suzierose on Thu Apr 05, 2012 1:22 am

I am an other..therapy is:
carfilzomib, dex, lenalidomide

[Dan D]

Re: Weekly Poll - Initial Myeloma Therapy

by Dan D on Thu Apr 05, 2012 2:32 am

What has happened to the BiRD regimen -- (Biaxin-Revlimid-Dex) -- which was previously shown to successful as a frontline therapy with low toxicity?

[Dan D]

Re: Weekly Poll - Initial Myeloma Therapy

by Dan D on Thu Apr 05, 2012 1:04 pm

Re: BiRd

The abstract below is from a 2010 retrospective study of newly diagnosed patients, comparing Revlimid & low-dose dexamethsone WITH and WITHOUT Biaxin, an antibiotic that appears to enhance dex action.

Strikingly, the median progression-free-survival was nearly twice as long in the WITH group (4 years) versus the WITHOUT group (2.3 years).

And there was a trend in this -- admittedly small -- tudy toward better overall survival in the WITH group versus the WITHOUT group.

Finally, the toxicities not only appear non-attributable to Biaxin but were often GREATER in the WITHOUT group.

Seems very promising as a low-toxicity front-line approach....especially as antibotics concern me a lot less as an addition to front-line therapy.

-------------------------------------------------
Am J Hematol. 2010 Sep;85(9):664-9.

Clarithromycin (Biaxin)-lenalidomide-low-dose dexamethasone (BiRd) versus lenalidomide-low-dose dexamethasone (Rd) for newly diagnosed myeloma.

Gay F, Rajkumar SV, Coleman M, Kumar S, Mark T, Dispenzieri A, Pearse R, Gertz MA, Leonard J, Lacy MQ, Chen-Kiang S, Roy V, Jayabalan DS, Lust JA, Witzig TE, Fonseca R, Kyle RA, Greipp PR, Stewart AK, Niesvizky R.

Time-to-progression (median 48.3 vs. 27.5 months, P = 0.071), and progression-free survival (median 48.3 vs. 27.5 months, P = 0.044) were higher with BiRd. There was a trend toward better OS with BiRd (3-year OS: 89.7% vs. 73.0%, P = 0.170). Main grade 3-4 toxicities of BiRd were hematological, in particular thrombocytopenia (23.6% vs. 8.3%, P = 0.012). Infections (16.7% vs. 9.7%, P = 0.218) and dermatological toxicity (12.5% vs. 4.2%, P = 0.129) were higher with Rd. Results of this case-matched analysis suggest that there is significant additive value when clarithromycin is added to Rd.

[JulievViz]

Re: Weekly Poll - Initial Myeloma Therapy

by JulievViz on Mon Apr 09, 2012 2:29 pm

Began with 10 mg Revlimid paired with 20 mg Dexamethasone. Then increased to 15 mg Revlimid and had an allergic reaction so dropped back to 10mg and increased Dex to 40 mg. Stayed at 10 mg Rev with 40 mg Dex until prep for STC. Had high dose Cytoxan then Neupogen then Melphalan then STC. Achieved CR and still in remission year and a half later! YAY!