Myeloma patients often wonder if or when they should switch myeloma treatments. When assessing patients and a possible change of treatment, Dr. Ajay Nooka of the Winship Cancer Institute usually begins by defining the patient’s risk level—standard risk, intermediate risk, or high risk, which are all determined by myeloma genetics.
For a newly diagnosed patient, or standard risk, the typical approach is a good induction treatment, go for a transplant, go for maintenance—whichever is most suitable based on the patient’s tolerance.
A patient of intermediate risk is usually the one to eventually make a change in treatment to suppress the disease for the longest period of time.
High risk patients are similar to standard risk patients when discussing treatment approaches, however their remission duration shrinks—so, in order to increase remission duration, it is recommended to obtain intense final maintenance in the later stages.
Treatment has to be adapted based on risk stratification for the individual.
“The goal in the bigger picture is…the longest benefit that you can get in the first time so that it turns into this survival advantage eventually.” -Dr. Ajay Nooka.