In this week’s #AskDrDurie, myeloma expert Dr. Brian G.M. Durie discusses frontline treatment options for newly diagnosed myeloma patients.
Foreign comes from a patient newly diagnosed and anxious to be sure if the correct selection has been made for that first choice of treatment and so the question is what treatment is recommended for a newly diagnosed patient and so in 2022 there are actually just a few straightforward choices to be made if a patient is in the category where a transplant
Autologous stem cell transplant is an option and the patient is interested and willing to pursue that course the standard therapy the standard of care therapy which is recommended is the combination of velcade revlimid and dexamethasone a triplet therapy vrd if the patient is living outside of the u.s just to mention sometimes the the vrd is not available then
Uh vtd or bcd can be used with thalidomide or cytoxan an alkalating agent substituting for the revlimid for a patient who is not eligible or wanting to pursue transplant the primary recommendation is to use the triplet of daratumumab revlimid index dara or d and this is the strong recommendation because of excellent results in terms of both response remission
Length and survival so a very clear option in this non-transplant setting outside of the u.s where the daratumama combination might not be available other combinations incorporating the alkylating agent’s malphalon and cytoxan may be considered what is quite important just to be aware of particularly in the united states is that the four drug combination in
Which daratumum is added to vrd can also be considered as an emerging option we still do not have full long-term comparative data to say that the remission and survival are definitely significantly improved but this is a a strong possibility as more data emerge again outside of the united states the combination of daratumumab with belkade thalidomide index may
Be considered because strong data are available for that combination from the trial called the cassiopeia trial and so bottom line there are some very simple options to be considered for initial therapy for a newly diagnosed patient vrd in the transplant setting and dara rd in the non-transplant setting and so please be aware of this and talk these over carefully
With your doctor if those will be feasible in your case and if there would be uh some small changes or nuances that would be necessary to follow through uh with these uh treatments
Transcribed from video
What treatment is recommended for a newly diagnosed patient? By International Myeloma Foundation
