Induction Therapy: Is it Working?
- Induction therapy is the first phase of multiple myeloma treatment that lays the groundwork for future treatment. It aims to eradicate as many cancer cells as possible and put the myeloma patient into remission.
- One of our experts says many patients achieve MRD negativity, or minimal residual disease negativity, after the delivery of six cycles of combination therapy.
- MRD testing is done with a bone marrow biopsy.
SurvivorNet talks with Dr. C. Ola Landgren, Leader of Experimental Therapeutics Program & Leader of Myeloma Service at Sylvester Comprehensive Cancer Center at the University of Miami, about the mechanics of induction therapy and how to monitor a patient to ensure desired effects.
What Is Induction Therapy?
Read MoreThe most commonly used induction therapy for myeloma is a combination of immunomodulatory, proteasome inhibitors, steroids, and/or monoclonal antibodies.
How Is Induction Therapy Monitored?
“For every cycle of therapy that’s given, typically blood work is repeated and would include testing of the blood with the monoclonal proteins and light chain proteins,” says Dr. Landgren. “These are markers of the disease and how much the disease is responding to the treatment.”
A response can usually be seen in a matter of a few cycles. “What we’re looking for is to see that these markers go down over time,” adds Dr. Landgrem.
RELATED: How Do I Receive Induction Therapy?
Dr. Landgrem acknowledges that many patients who begin induction therapy see promising results. “These days, we see very good responses in the vast majority of patients early on. We see, after one or two months, very dramatic improvements in these blood markers.”
According to Dr. Landgren, if a patient shows a positive response to induction therapy as judged by these blood markers, “we would typically consider doing a bone marrow biopsy.” Repeated imaging studies may also be performed, including a PET CT.
“We are looking in the bone marrow to determine if the patient has any detectable residual disease or not,” explains Dr. Landgren. “This is what we refer to as minimal residual disease testing or MRD testing. In many patients, we can achieve MRD negativity after the delivery of six cycles of combination therapy.”
Doctors use all of this information to determine if a patient is progressing on induction therapy and whether or not they are ready to move on to the next phase of treatment, consolidation.
The Future of Induction Therapy
Dr. Landgren discusses the state of induction therapy and where it’s headed. “There are recent studies showing that if you receive the best available combination therapies and achieve MRD negativity, compared to if you have less good therapy with a transplant and also achieve MRD negativitythat you would have the same progression-free follow-up time.”
Dr. Landgren emphasizes the importance of induction therapy and how it lays the groundwork for future treatment. “It doesn’t really matter how you are treated. It’s how good of a response you have.”
RELATED: Treating the Side Effects of Induction Therapy
Treatment options for multiple myeloma are expanding all the time, and it’s important to stay up to date on the latest advances. If you or a loved one has been diagnosed with multiple myeloma, be sure to consult with an expert to discuss your individual situation and the best possible treatment plan.
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