And while you canât completely avoid a relapse, you may be able to spot certain signs and symptoms earlier, which could lead to better care. Symptoms can include: yellowing of your skin or the white part of your eyes, skin that dents (pits) when pressed for a few seconds. vs7.1. We work to find the best treatments and make them available, to improve patient care and, ultimately, find a cure for myeloma. Pomalidomide (CC4047) plus low-dose dexamethasone as therapy for relapsed multiple myeloma. Mateos MV, Estell J, Barreto W, et al. As the scientific community gains a deeper understanding of disease biology, treatment choices are evolving. Including Oral Chemotherapy and Immunotherapy.â. A differential impact of myeloma therapies on infection risk has been established, with the treatment phase also having an effect. Out of these cookies, the cookies that are categorised as necessary are stored on your browser as they are as essential for making sure the website works properly for you. Multiple myeloma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. With our research into CD38 and other investigational MM treatments, we are building on our rich legacy in oncology and pipeline of potential therapies to make a meaningful difference where it’s needed most. With some triplet regimens for RRMM, it appears reasonable to halt treatment once a stable plateau has been reached in order to minimise the risks of ongoing serious toxicity.24 It is also common for patients themselves to request a treatment-free period in order to reduce the need for clinic visits and alleviate drug-associated toxicities. Avet-Loiseau H, Fonseca R, Siegel D, et al. In this situation, Darzalex is used with the medications pomalidomide (Pomalyst) and dexamethasone. Can darzalex/daratumumab truly help someone in this condition …?? The tolerable all-oral ixazomib + Rd regimen may therefore provide a useful therapeutic approach for patients with high-risk cytogenetics which allows for prolonged active treatment, thereby enabling extended control of aggressive disease.57, Data from the pivotal phase III ASPIRE (Study Comparing Carfilzomib, Lenalidomide and Dexamethasone [KRd] versus Lenalidomide and Dexamethasone [Rd] in Subjects with Relapsed Multiple Myeloma) and ENDEAVOR trials indicate that carfilzomib is a more potent proteasome inhibitor than bortezomib for patients harbouring high-risk cytogenetic abnormalities; however, it is unable to completely negate the unfavourable impact on prognosis. In frail and older patients especially, the treatment during the first relapse should induce a response without adding too much toxicity. He’s already on many of the supplements that you have discussed on your website. E: [email protected]. Conference | ASH Annual Meeting and Exposition. By examining the available clinical efficacy and safety data for the novel approved agents in RRMM in these specific subgroups, we aim to show how treatment can be tailored and targeted to meet individual patient needs and thereby provide optimised clinical care for RRMM. You and your dad will get more out of the consultation if you can email me your dad’s most recent diagnostic information- blood, urine, imaging. In the phase III ELOQUENT-2 trial (Study of Lenalidomide and Dexamethasone With or Without Elotuzumab to Treat Relapsed or Refractory Multiple Myeloma), the benefit of adding elotuzumab to Rd was retained in patients aged 65 years or older, with mAb combination therapy actually achieving better hazard ratios (HRs) for PFS than in the younger patient cohort (HR 0.65 for patients aged â¥65 years versus 0.75 for patients aged <65 years).11 In the CASTOR study (Addition of Daratumumab to Combination of Bortezomib and Dexamethasone in Participants with Relapsed or Refractory Multiple Myeloma), similar findings were seen with daratumumab + Vd, where the positive impact on PFS was greater in elderly patients aged â¥65 years versus younger MM sufferers (HRs of 0.44 and 0.35, respectively).13 Emerging data also support the value of daratumumab monotherapy in older patients with RRMM, with almost a third of very elderly patients (aged â¥75 years) responding to treatment in the SIRIUS trial (Efficacy and Safety Study of Daratumumab in Patients with Multiple Myeloma Who Have Received at Least 3 Prior Lines of Therapy [Including a Proteasome Inhibitor (PI) and Immunomodulatory Drug (IMiD)] or Are Double Refractory to a PI and IMiD).40, From a practical perspective, the simplicity and convenience of ixazomibâs weekly oral dosing schedule, together with its favourable safety profile, highlight it as a good option for elderly or frail patients with an asymptomatic relapse. They are more susceptible to drug-induced AEs, less resilient to treatment-related toxicities and more likely to suffer with coexisting comorbidities.17 Polypharmacy is also a potential confounding factor, introducing the real risk of drugâdrug interactions with antimyeloma medications. Treatment aims to bring the myeloma back under control and a period of plateau or remission follows. This review will examine the key treatment challenges and unmet needs which currently exist in RRMM including the adverse impact of treatment on quality of life (QoL), the toxicity burden of therapy and issues of clonal evolution and treatment-resistant disease. Control and a period of plateau or remission follows to bring the myeloma back under control a! You have discussed on your website diagnosis, treatment choices are evolving deeper understanding of disease biology, treatment follow-up... Avet-Loiseau H, Fonseca R, Siegel D, et al, with treatment! 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