This year’s American Society of Hematology (ASH) Annual Meeting was filled with fascinating new treatments and treatment combinations which left me thinking that there is so much more information to digest as a patient than when I was diagnosed in 2010. Over my 14 years as a myeloma patient, I’ve been through 5 lines of therapy. In conjunction with my specialists and local hematologist, I’ve made treatment decisions over the years at each relapse. I used the available information to help me have a candid discussion with my physicians before coming to a decision. Several of the options seemed fairly obvious at the time, given the more limited number of choices.
In 2010, there was no question that Revlimid (lenalidomide), Velcade (bortezomib), and dexamethasone was the way to go for upfront treatment. It was somewhat comforting that there wasn’t a need to decide on a treatment plan on day 1 when your head was still spinning from the fact you had cancer and all the new terminology. If you were transplant-eligible, it was basically assumed you would do this following your upfront cycles.
In 2024, the standard of care for a newly diagnosed patient is a combination of 4 medications which includes the addition of a monoclonal antibody – Darzalex (daratumumab) or Sarclisa (isatuximab). Which is best for each individual patient? These combinations have proven to produce very deep responses in most, so is there a need for a transplant upfront or ever? Some physicians still favor transplant, some say save it for relapse, and some aren’t convinced the exposure to the high dose chemotherapy is necessary.
At this year’s ASH, TECVAYLI (teclistamab) was presented in several abstracts as a possible future option in upfront and maintenance therapy. This drug is currently only used after multiple lines of therapy. If the trials prove this out and it gets approved by the Federal Drug Administration (FDA), this adds yet another layer of complexity to the treatment sequencing puzzle. The passion the researchers display at ASH is comforting because they are doing everything they can to provide more and better options for myeloma patients. On the flip side, this makes the need to have a myeloma specialist on your team essential to help understand the options and help you evaluate the options.
At my first Support Group Leader Summit in 2011, I vividly remember Susie Durie standing before the group and exclaiming that knowledge is power! She encouraged us to be as informed as possible and be an advocate for ourselves during your entire myeloma journey and to encourage our support group members to do the same. Those words could not ring truer today. Thanks to the International Myeloma Foundation (IMF), we have the tools to be informed. Take advantage of reading the blogs from all participants in this year’s meeting because each provides information for you to consider, call the InfoLine, ask Myelo questions on the IMF website, register for the December 18th webinar (IMWG Conference Series – Making Sense of Treatment) — do whatever works best for you to stay informed and on top of the latest developments. This will help you put all the myeloma pieces of the puzzle together more easily!
Linda Huguelet, Chattanooga Multiple Myeloma Networking Group
@LindaMYELOMA