Multiple Myeloma Treatments Drugs: Treatment Options

Multiple myeloma treatments drugs - Some drug myeloma consists of two types. One type of therapy is to control the myeloma or kill myeloma cells. Another way is to relieve symptoms and regulate the complications of the disease (such as bone damage) and side effects of treatment. This is called supportive therapy. There are currently 5 classes of drugs for the treatment of multiple myeloma: the immunomodulatory drugs, proteasome inhibitors, chemotherapy, inhibitors of inhibitors (inhibitors of HDTA) and steroids. (Multiple myeloma drug therapies)
Multiple Myeloma Treatments Drugs

Multiple Myeloma Treatments Drugs: Monoclonal antibodies

Darzalex ™ (Tartumaa): Darzalex ™, also known as karatumanov, is a monoclonal antibody first approved for use in multiple myeloma. Darzalex make Janssen Biotech and Genmab.

Empliciti ™ (elotuzumab): Empliciti ™, also known as elotuzumab is a monoclonal antibody that is approved for use in multiple myeloma. Empliciti made by Bristol-Myers Squibb and AbbVie.

IMD (immunomodulatory drugs)
Revlimid® (lenalidomide): Oral medications, which are effective across the spectrum of myeloma disease.

Pomalyst® (pomalidomide): IMiD that is similar to Revlimid but is more potent. It is approved by the FDA for use in patients with myeloma recurrent / refractory and is being studied on the type of the other patients.

THALOMID® (thalidomide): Old drugs, proven effective in the whole spectrum of myeloma disease; peripheral Neuropathy (problem with nerves) is a common side effect and can be irreversible. It is rarely used in the United States.

Inhibiting the Proteasome
Ninera (ixazomib): The U.S. administration regarding the control of the administration of food and medicines given permission to Ninlaro (ixazomib). Ninlaro is an inhibitor of proteasome first oral and approved in combination with Revlimid (lenalidomide) and dexamethasone.

Velcade® (bortezomib): Medicines used in the entire spectrum of myeloma disease. Taken by injection under the skin (subcutaneous) or intravenously. Patients who have a change in the DNA of t (4; 14), should receive a treatment regimen that includes a proteasome inhibitor.

Kyprolis® (carfilzomib): Inhibiting the proteasome a new given intravenously. This is approved by the FDA for use in. Patients with myeloma relapsed / refractory and is being studied in other patients.

Multiple Myeloma Treatments Drugs: Chemotherapy

Doxil (injection doxorubicin HCl liposome): The drug is administered intravenously in patients with myeloma recurrent / refractory, usually combined with Velcade. Side effects including lesions of the mouth, swelling, blisters on the hands or feet, and possible heart problems. It is rarely used.

Chemotherapy Alkylator
Other types of chemotherapy drugs, which for many years used to treat myeloma. They can be used together with other drugs for myeloma. Examples are melphalan and cyclophosphamide.

Inhibitor of Historical detail (inhibiting HDAC)
Farida (Panobinostat): Farydak® is an inhibitor of gap, operated with a combination of Velcade® (bortezomib) and dexamethasone for patients with myeloma multi-refractory / refractory. She is introduced in the form of the mouth.

Steroids (corticosteroids)
Dexamethasone (dex) and prednisone: a Drug used for decades to treat myeloma throughout the spectrum of disease; Used in combination with other drugs for myeloma.

A Transplant Of Stem Cells
Chemotherapy high dose and transplant stem cells. The use of doses of chemotherapy more high, usually melphalan, followed by transplantation of hematopoietic stem cells to replace healthy cells that know by chemotherapy.

Options for Initial Therapy
The choice of the initial treatment of the patient depends on many factors, including features mieloma itself, the risk of the risk of the effects of companions, convenience, and familiarity of the treating doctor with the regiment given. Mode, which is an option for patients who become candidates for stem cell transplant, may also be suitable for patients who are not candidates for transplantation. Treatment for myeloma consists of three twins (three drugs) or a pair (two drugs). Usually, three times is preferred. You can also consider the possibility of doubling, particularly in cases where the effect of companion from the triplet is a concern. A clinical trial is an option that can be discussed by patients with their doctors.

Triplets include:
  • Revlimid-Velcade-dex (RVD): Revlimid plus Velcade and dex (RVD) is one of the most frequently used modes. Studies have shown that this combination gives a very high response rate among patients with newly diagnosed symptomatic myeloma.
  • Velcade-cyclophosphamide-Dec (VCD or CyBorD): High response rates and rapid responses have been observed in studies of phase II (the second stage of drug studies designed to test effectiveness).
  • Velcade-Thalomid-dex (VTD): It was demonstrated that the combination of Velcade, Thalomid and dexamethasone is highly effective in the study phase III (the most advanced stage of development of the drug).

The twins (most often used in elderly or frail patients) include:
  • Revlimid-dex (Rd): The effectiveness of Revlimid-low-dose-dex are well known.
  • Velcade-dex (Vd): It is shown that Velcade in combination with dexamethasone as initial therapy effective in patients whose myeloma has characteristics that indicate a more aggressive disease, as in patients without these characteristics.

Multiple myeloma treatment drugs - Also studied the combination of four drugs. The problem with these schemes is the potential for increased side effects, and research continues to determine the balance of effectiveness and tolerability. Schemes based on Melphalan (MP) are also options for patients who are not candidates for transplantation. These schemes are rarely used in the United States, because there are effective options with fewer side effects.

You and your doctor will discuss a treatment regime that suits you.

The duration of therapy for candidates for stem cell transplantation
Patients who are candidates for transplant may choose to transplant after three to four cycles of initial therapy to reduce the number of myeloma cells (also known as induction therapy) or may decide to continue the initial therapy and, possibly, to consider transplant later in the disease course. Supportive therapy, which is an additional treatment received after the primary therapy to improve long-term results, often follows transplantation.

The duration of therapy for patients without a transplant
Duration of therapy varies for patients who are not candidates for transplant or who choose not to undergo transplant. Although some doctors recommend continued treatment until then, until there is evidence of progression of myeloma, others suggest treatment for regular intervals, usually as long as the response of the disease to the treatment reaches a plateau. Specific features of the myeloma, your preferences and the perspective of your doctor is a consideration in determining duration of therapy. At this time, studies are being conducted to determine the best approach.

The choice and dose of drug therapy depend on many factors, including the level of cancer, as well as the function of the patients with age and kidneys. If you are planning a stem cell transplant, most doctors avoid the use of certain drugs, such as melphalan, which can damage the bone marrow.