What to Expect During Induction Therapy
- Induction therapy is the first treatment most people with multiple myeloma receive.
- it includes a combination of three or four medications given over a series of 21 – 30 day treatment cycles.
- The medications come as an injection, an infusion through a vein, a pill, or a capsule.
Induction Medications
The usual induction therapy combines three drugs. One common combination is called VRD for short. It includes:
- Bortezomib (Velcade) a proteasome inhibitor
- Lenalidomide (Revlimid) an immunomodulatory drug
- Dexamethasone a steroid
How to Take Induction Therapy
Velcade used to be an infusion given through an IV. That required you to sit in an infusion center or a hospital while the medicine went into your bloodstream."In general, we are now moving away from infusion-based therapies," Dr. Krisstina Gowin, assistant professor of medicine at the University of Arizona Cancer Center, tells SurvivorNet. "Typically, those take longer and you have to have an IV placed." If your doctor adds Darzalex, that does still come as an infusion, but it is now most commonly given subcutaneously.
RELATED: How Does Induction Therapy for Multiple Myeloma Work?
Today Velcade is available as a subcutaneous injection a shot you get just underneath your skin. "What that means is that therapy times are shorter. And often there can be fewer side effects associated with those," Dr. Gowin adds.
You take both Revlimid and dexamethasone by mouth. Revlimid comes in a capsule. Dexamethasone is a pill. You give yourself these medications at home.
Getting Started
You'll get induction therapy in 21-30 day periods called cycles. Expect to have several cycles of treatment over a few months.
Your treatment team should talk you through the process of induction therapy. "I tell patients that they’ll be with me in the cancer center weekly for the first couple of months," Dr. Gowin says. "They'll come in, have lab tests, sometimes see me or another member of our care team, and then go upstairs for their injections."
The doctors and nurses should explain not only what you can expect during the injections, but also how to take your oral medications at home. "It depends on the regimen and the way that’s dosed by your doctor. But usually, that’s a pill a day that you take for three weeks on, one week off," she adds.
This process might be very new to you. Ask questions so you'll know what to do and what to expect from your treatment. Also find out who to call if you run into any problems while managing your treatment at home.
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