When your multiple myeloma comes back within about a year, your disease is generally classified as ‘high risk.’ We acknowledge that this sort of language can actually be even more frightening for some people, but it’s important to understand at this point doctors will often talk to you about a more aggressive treatment regimen in the management of the relapse.
The quicker you contain the myeloma, the better the patient does, says Dr. Vincent Rajkumar who treats patients at The Mayo Clinic.Read More
Dr. Rajkumar also says that a combination of four drugs may also be considered so the myeloma can be controlled more quickly.
A lot of treatment at this stage of myeloma involves a judgement call. One of the key drivers for decision making around aggressive myeloma relapse is how you as the patient react to lenalidomide (brand name Revlimid) as a therapy.
With this factor in mind, there are eight to ten different four-drug combinations which can be tried in the management of aggressive myeloma which may include the following drugs:
- Velcade (bortezomib), Kyprolis (carfilzomib), and Ninlaro (ixazomib): These are proteasome inhibitors. In other words, they disrupt the mechanism by which cancer cells break down proteins. This build-up of protein within the cell eventually causes the cells to die.
- Revlimid (lenalidomide) and Pomalyst (Pomalidomide): These are known as immunomodulatory drugs. In other words, they activate your immune system to target cancer cells and kill them like they would any other infection.
- Dexamethasone: This is a steroid drug that prevents inflammation and associated pain from myeloma, and it can even help kill myeloma cells at high doses.
- Dara (Daratumumab): This is known as an immunotherapy. More specifically, it is a monoclonal antibody that ‘tags’ cancer cells for recognition by the immune system.