When should patients consider altering their treatment regimen?

Transcript:

This week’s “Ask Dr. Durie” is an important question coming from someone anxious to consider taking CAR T immune therapy. The question is: If the current therapy is working well, is it worth stopping that to consider taking CAR T therapy?   

Now, obviously, the results with the new CAR T therapies have been extremely promising, but the simple answer to this question is no. You really should not stop treatment that’s working well. We struggle hard to find combinations that work, and if you are taking a combination therapy for your myeloma that’s keeping it in remission, and you’re able to tolerate the therapy, it’s important to continue with that therapy. It’s hard achieving it and it’s good to continue it.   

There are a number of examples, and this particular patient gave an example of taking a venetoclax combination in the setting of having the translocation (11;14). venetoclax is an agent that works well in this setting with the (11;14) translocation. In this case, it’s particularly important to stick with that therapy that could continue to produce a remission for a significant length of time. 

The other bigger picture item is that every month that you stay in remission, new research is continuing. We’re learning more about all of the new and evolving therapies. Every month gained is a month gained, and new options, potentially, and new refinements that can make any decision process more refined and better in the future.   

For this particular question, the BOTTOM LINE: No, I recommend sticking with your current therapy if it’s working well and you’re tolerating it. Even although we’ve had really exciting results with the CAR T therapies including the recently approved Abecma® the commercially available CAR T therapy with the bb2121 product. Definitely keep that in reserve is the way to go and stick with what you’re doing for now.