What to Think About Before Induction Therapy
- Induction therapy is the first treatment you will receive for newly-diagnosed multiple myeloma.
- The goal of this treatment is to put you into remission.
- The typical induction therapy includes a combination of three drugs, but many doctors add a fourth drug into the mix.
"The goal really is to tackle those plasma cells, the myeloma cells in the bone marrow, and to get you into a deep remission," Dr. Krisstina Gowin, assistant professor of medicine at the University of Arizona Cancer Center, tells SurvivorNet. A stem cell transplant will deepen that remission.
The Three-Drug Approach
Read MoreImmunomodulatory drugs work in different ways to stop the growth of multiple myeloma cells. Steroids both bring down inflammation and act against the cancer.
One common triplet combo is nicknamed VRD:
- Bortezomib (Velcade) a proteasome inhibitor
- Lenalidomide (Revlimid) an immunomodulatory drug
- Dexamethasone a steroid
Adding a Fourth Drug
Sometimes doctors add a fourth drug into the mix the monoclonal antibody daratumumab (Darzalex). "Many of us are now moving to this quadruplet-based approach," Dr. Gowin says. Studies are showing a survival advantage in people who take four drugs instead of the standard three.
RELATED: Finding the Right Drug Combination for Multiple Myeloma Induction Therapy
Over the next few years, doctors will have more evidence from studies to guide their choice of drugs for induction. For now, each doctor has their own preference. "In my practice right now, I am doing quadruplet therapy for those who are newly diagnosed, and taking them to transplant if I can," she adds.
After Induction Therapy
The hope is that induction therapy will get you into remission. That means you have as few cancer cells as possible in your bone marrow.
The next step is to have an autologous stem cell transplant. "Autologous means you are your own stem cell donor," Dr. Gowin says.
You'll first get high-dose chemotherapy to kill any remaining cancer cells in your bone marrow. That's followed by an infusion of the stem cells your medical team collected from you before the chemo treatment.
Multiple myeloma treatment can look a little bit different for everyone. Some people get VRD. Others get different combinations of drugs for triplet therapy. Still others get four drugs.
Before you start treatment, talk to your doctor about what you can expect. Know what your treatment can and can't do for you. Also find out what side effects it might cause, so you won't have any surprises along the way.
Learn more about SurvivorNet's rigorous medical review process.
