Hi Guys,
The Dr is suggesting that we start with CyBorD and then as a second stage do the SCT.
i would like to know from you the one who gone through this, what does CyBorD, VCD at the end achieve?
If one do not want to do the SCT as a next step what are the options after CyBorD, VCD?
as always thanks for your thoughts and valued comments.
Forums
6 posts
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orchid - Name: orchid
- Who do you know with myeloma?: brother
- When were you/they diagnosed?: dec 27 2013
- Age at diagnosis: 45
Re: What does (CyBorD, VCD) achieve?
Orchid,
You might find this post on SCT versus a chemo-only approach to be insightful
https://myelomabeacon.org/forum/looking-for-feedback-on-recommended-first-round-treatment-t1502.html
You might find this post on SCT versus a chemo-only approach to be insightful
https://myelomabeacon.org/forum/looking-for-feedback-on-recommended-first-round-treatment-t1502.html
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: What does (CyBorD, VCD) achieve?
just wanted to say thanks to all of you. this forum is so truly supportive and informative - it's great. Multibilly, the post you're referring to bears once more also loads of input for me - thanks!
and - have a good start into 2014, it is what it is.
heike
and - have a good start into 2014, it is what it is.
heike
Re: What does (CyBorD, VCD) achieve?
Greetings from Seattle Orchid,
CyBorD (or VCD) are common combination chemotherapies given to myeloma patients. CyBorD and VCD are very similar. They are routinely used for "induction" meaning they are used as the first line of chemotherapy in newly diagnosed patients. The goal of this chemotherapy is to get the best possible response...meaning to achieve the maximum decrease in the amount of myeloma in a patients body. Generally CyBorD/VCD were designed to be given for 4-6 cycles in preparation for an autologous stem cell transplantation. However oncologists have adopted these regimens for use in nontransplant patients as well.
In the Phase II study published results of the VCD/VTD regimen produced an overall response rate of 95%, including 19% stringent complete response (sCR), 26% CR, and 57% of patients had at least a very good partial response or better.
In the Phase II published results for CyBorD the overall response rate (at least a PR) for all 63 patients was 90% with 41% CR/nCR and 60% VGPR or better.
One cannot directly compare these studies but the results are excellent and similar. Both studies were relatively small with under 100 patients in each.
After induction treatment the patient and their oncologist must make a decision as to stem cell transplantation or not. In 2014 a stem cell transplantation is still the standard of care around the world for eligible patients. In some circumstances it is reasonable to postpone the transplant until 1st relapse.
I am glad that you found the Myeloma Beacon as there is a wonderful community of patients and health care providers volunteering through this site to help patients with myeloma.
I wish you good fortune in your fight with this challenging disease. I recently returned from the American Society for Hematology meeting in New Orleans and without a doubt there is hope ! Our treatments are improving rapidly.
CyBorD (or VCD) are common combination chemotherapies given to myeloma patients. CyBorD and VCD are very similar. They are routinely used for "induction" meaning they are used as the first line of chemotherapy in newly diagnosed patients. The goal of this chemotherapy is to get the best possible response...meaning to achieve the maximum decrease in the amount of myeloma in a patients body. Generally CyBorD/VCD were designed to be given for 4-6 cycles in preparation for an autologous stem cell transplantation. However oncologists have adopted these regimens for use in nontransplant patients as well.
In the Phase II study published results of the VCD/VTD regimen produced an overall response rate of 95%, including 19% stringent complete response (sCR), 26% CR, and 57% of patients had at least a very good partial response or better.
In the Phase II published results for CyBorD the overall response rate (at least a PR) for all 63 patients was 90% with 41% CR/nCR and 60% VGPR or better.
One cannot directly compare these studies but the results are excellent and similar. Both studies were relatively small with under 100 patients in each.
After induction treatment the patient and their oncologist must make a decision as to stem cell transplantation or not. In 2014 a stem cell transplantation is still the standard of care around the world for eligible patients. In some circumstances it is reasonable to postpone the transplant until 1st relapse.
I am glad that you found the Myeloma Beacon as there is a wonderful community of patients and health care providers volunteering through this site to help patients with myeloma.
I wish you good fortune in your fight with this challenging disease. I recently returned from the American Society for Hematology meeting in New Orleans and without a doubt there is hope ! Our treatments are improving rapidly.
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Dr. Edward Libby - Name: Edward Libby, M.D.
Beacon Medical Advisor
Re: What does (CyBorD, VCD) achieve?
Thanks Multibilly for the links, it helps!
Thanks Dr. Edward Libby for your detailed response. It is greatly appreciated.
In our case, with up to 85 % plasma cell in the bone marrow and extremely high lambda, what are thoughts on whether a postponement of SCT is a good idea?
Thanks Dr. Edward Libby for your detailed response. It is greatly appreciated.
In our case, with up to 85 % plasma cell in the bone marrow and extremely high lambda, what are thoughts on whether a postponement of SCT is a good idea?
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orchid - Name: orchid
- Who do you know with myeloma?: brother
- When were you/they diagnosed?: dec 27 2013
- Age at diagnosis: 45
Re: What does (CyBorD, VCD) achieve?
Hello again orchid,
Without alot more information it would be unfair for me to try and make a fully informed judgment. From a myeloma perspective your brother is quite young (45). The FISH cytogenetics are important here and if he has the t(4;14) translocation there is evidence that bortezomib induction followed by stem cell transplantation followed by bortezomib based consolidation/maintenance can signifcantly improve his liefspan.
You need to find out what the cytogenetics/FISH results are. These results have a very signifcant bearing on prognosis as does the International Staging System Stage (ISS).
If your brother does not achieve a CR with induction therapy I would tend to recommend a first line (or upfront ) stem cell transplant to try and achieve a complete remission followed by maintenance therapy.
Again, I wish you good fortune in dealing with this difficult disease.
.
Without alot more information it would be unfair for me to try and make a fully informed judgment. From a myeloma perspective your brother is quite young (45). The FISH cytogenetics are important here and if he has the t(4;14) translocation there is evidence that bortezomib induction followed by stem cell transplantation followed by bortezomib based consolidation/maintenance can signifcantly improve his liefspan.
You need to find out what the cytogenetics/FISH results are. These results have a very signifcant bearing on prognosis as does the International Staging System Stage (ISS).
If your brother does not achieve a CR with induction therapy I would tend to recommend a first line (or upfront ) stem cell transplant to try and achieve a complete remission followed by maintenance therapy.
Again, I wish you good fortune in dealing with this difficult disease.
.
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Dr. Edward Libby - Name: Edward Libby, M.D.
Beacon Medical Advisor
6 posts
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