Published Apr 21, 2021

For Newly Diagnosed Multiple Myeloma Patients– The New Four Drug Combination Showing Unprecedented Results

A study from Jama Oncology has found four drugs show huge promise in increasing progression-free survival and overall survival in multiple myeloma patients. An expert talks to SurvivorNet about what this means for those with myeloma.

Shelby Black

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New Hope in Multiple Myeloma

A new four drug treatment for newly-diagnosed multiple myeloma patients is being called “unprecedented” in its effectiveness
Results of a new trial find that combining drugs daratumumab (Darzalex), bortezomib (Velcade), lenalidomide, and dexamethasone (VRd) increased progression-free survival and overall survival in the patients.
Daratumumab was initially used in later-stage multiple myeloma treatment, but has shown promise as a first-line treatment for those newly diagnosed.
Multiple myeloma is a rare cancer that forms in a type of white blood cell called a plasma cell. This causes plasma cells to grow out of proportion to other cells and cause a variety of symptoms.

There’s promising new hope for those battling rare blood cancer multiple myeloma. In a clinical trial, researchers found that combining four drugs as a first treatment course showed remarkable results in increasing the overall survival and progression-free survival in patients battling the disease.

“These results are very encouraging to give us another set of tools to get better, longer time for patients to live their lives and have a good quality of life to do the things they may not have thought they could do when they were first diagnosed with multiple myeloma,” Dr. Nina Shah, a hematologist who specializes in the treatment of multiple myeloma at UCSF Medical Center, tells SurvivorNet. “In multiple myeloma, we are always trying to get the deepest response that we can get. And we know if we can get that upfront, we'll probably have a longer time that the patient is in the first remission.”

The new data, published in the respected journal Jama Oncology, examined results from a clinical trial which combined the drug daratumumab (Darzalex) with an existing three drug treatment regimen for those newly diagnosed with multiple myeloma. The existing drugs are carfilzomib (Kyprolis), lenalidomide (Revlimid), and dexamethasone. Doctors call the regime “KRD.”

Darzalex is an anti-CD38 drug, which blocks the CD38 protein in the body and can help a person’s immune system fight myeloma. Researchers combined Darzalex with three other drugs including bortezomib (Velcade), lenalidomide, and dexamethasone (VRd) and found impressive results. This drug combination was given to 41 eligible patients, and among them progression-free survival (PFS) and overall survival (OS) rates at 1 year were 98% and 100% respectively. This means that in the patients given this treatment regime, their disease did not advance or progress.

“I'm impressed with the data, and I'm not surprised because they are using four very known effective drugs to treat myeloma,” Dr. Shah says. “This is very encouraging. I do think to understand the true benefit of this we need randomized control trials. We not only have to understand what the benefit is, but the toxicity and also the cost.”

Dr. Paul Richardson explains how daratumumab is working in multiple myeloma first-line treatment

What is Multiple Myeloma?

Multiple myeloma is a rare cancer that forms in a type of white blood cell called a plasma cell. Multiple myeloma causes plasma cells to grow out of proportion to other cells, which can lead to a handful of symptoms. These can include weakness, fatigue, dizziness, shortness of breath, bones easily fractured and urinary issues. Seeing as many of these systems could point to other types of illnesses, it’s key to talk to your physician about these symptoms in order to rule out multiple myeloma as an option. Also, getting a second opinion can be a valuable resource when it comes to this particular cancer, especially since it can be misdiagnosed at times.

Fortunately, for those diagnosed with multiple myeloma, there has been a huge revolution in treating this complex and rare cancer. Newer drugs, including combination therapies, more-refined stem cell transplants, and the recent emergence of immunotherapies, have led to a significant change in viewing and ultimately treating multiple myeloma.

With current advancements, average length of life with multiple myeloma has become four times what it was just two decades ago. There has been so much innovation already that individuals who would only live for a few years after treatment are now living for a decade or more, and things will likely only get better from here.

Dr. Nina Shah breaks down the basics of multiple myeloma

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Patient Pathfinder

We’re here to help. Have you had any treatment for myeloma yet?

You might want to check out some top experts outlining the initial treatment for myeloma.

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Multiple Myeloma Initial Treatment

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Got it. Are you looking for maintenance treatment?

You might want to check out some top experts outlining maintenance treatment for myeloma.

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Multiple Myeloma Maintenance Treatment

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Ok. Has your Myeloma come back? Here are some useful resources:

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Multiple Myeloma Reoccurrence Treatment

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If you’ve had at least four treatments that have not worked or stopped working you might be a candidate for a treatment called CAR T Therapy.

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CAR-T Therapy for Multiple Myeloma

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