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Published on May 21, 2021
Five Things Doctors Want Myeloma Patients and Caregivers to Know
The following article includes highlights from the Myeloma Connections: Dinners with the Docs series.
With promising new therapies, clinical trials, and FDA approvals, it can be tough to keep up with the ever-changing landscape of multiple myeloma treatment and care. During a recent Patient Power Dinner with the Docs event, where patients and experts discussed the latest myeloma news while sharing a virtual dinner via Zoom, Edward A. Faber, Jr., DO, MS, a hematologist and transplant and cellular therapy specialist from OHC (Oncology Hematology Care, Inc.) in Cincinnati, Ohio, provided several important updates.
Here are five key takeaways for multiple myeloma patients and care partners:
1. COVID-19 safety measures are still essential.
“We should all continue universal precautions: quarantining, distancing, washing hands, and wearing masks,” Dr. Faber said. “The [COVID-19] vaccine offers an opportunity to control the infection, but just like the flu vaccine, you can still have the virus transmitted to you, and you may experience symptoms, including the ability to shed the virus to others. One of the goals of vaccination over time is to cut down the transmission, as well as lessen the symptoms of active infections that we've seen in the past.”
2. Switching drug classes can extend remissions and create opportunities for recycling therapies.
“Although we do not have randomized, prospective clinical trials, I believe in switching classes of medicines,” Dr. Faber said. “If you look at bortezomib [Velcade] and lenalidomide [Revlimid], for example, if we pair those just with corticosteroids, we know what that provides. When you put all three of those together, it provides benefits and responses more than are just additive. There is a synergy that we see with these different classes of drugs, which is why, unlike other cancers, when patients relapse on a certain class of drug, you no longer find that useful. But you can recycle classes of drugs with different agents and look for that synergy to extend out the time of remissions [in patients with multiple myeloma]. So, it's a little bit of a different concept than I find with other blood cancers and cancers in general.
3. The highest dose is not always the best dose when treating multiple myeloma.
“Unlike medicines that we use for heart, lung, liver, and kidney issues, for example, dose adjustments and dose reductions are very common in our field,” Dr. Faber explained. “That’s a common part of what we do from day to day... Efficacy and response don't always necessarily rely on receiving the highest doses. During clinical trials, there is constant monitoring to determine the appropriateness of dose reductions. So, it really gets down to keeping the medications safe for the patients while preserving the responses, or the efficacy. In the world of Covid, that's even more important now today than it ever was.”
4. Patients can access promising new therapies by participating in clinical trials.
“Where I see a good opportunity and benefit is when a drug is showing very good promise and [a clinical trial] offers it in earlier lines of therapy or in a different combination than what is currently available,” Dr. Faber said. “That provides an opportunity for the patients to receive these medications earlier than indicated. We should consider clinical trials throughout the patient’s journey, regardless of the line of therapy, especially if we have something novel or a bit different. When we’ve exhausted all available therapies, and there’s a promising newer therapy, we can look to early phase 1 and phase 2 trials to try to help that patient.”
5. Multiple myeloma research is making rapid progress.
“If we look at all the different blood cancers over the last decade, I can't think of one that has had more approvals, more medications, and subsequent combinations [than multiple myeloma],” Dr. Faber said. “When I started doing this almost 20 years ago, when patients were first diagnosed, they would ask me, ‘How long do I have to live?’ and I would say, ‘You have a one in three chance at five years.’ Now we're talking about seven-year, 10-year, and beyond survivals with a much better quality of life than traditional chemotherapies. It can't be more encouraging with these new medications, new combinations, and now immunotherapies. It's going to be very interesting to see how we treat our myeloma patients in the next three to five years.”
The Patient Power community is grateful to Dr. Faber and all of the experts and hosts who share their time and knowledge. For more information about Dinner with the Docs or to register for an upcoming event, visit Patient Power Events or email firstname.lastname@example.org.
Support for this series has been provided by Karyopharm Therapeutics. Patient Power maintains complete editorial control and is solely responsible for program content.
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