Hi Paul,
I must say that you are very calm given the circumstances of your treatments so far but DT Pace certainly seems like a big hitter and you don't need to come down too much to start the harvest and SCT processes.
Also, just because your treatments were part of your frontline therapies doesn't mean that you can't try them again when you finally relapse from your long term SCT remission. Velcade is the first stop but it is there because NICE places it there… its role has never meant to gain a potential medium/long-term remission (like a SCT or Revlimid) it is a short, sharp shock treatment to prepare for the 2nd SCT… but NICE insist that everyone has it in the order they have promised payment for… so we all get it whether we need it or not. Revlmid is another matter, so are the new drugs on the horizon such as Carfilzomib et al.
I read several articles regarding CT Pace and fond this one interesting:
[quote]
DTPACE Is Effective Induction for Autotransplantation in Patients With Myeloma.
NEW YORK (Reuters Health) Aug 18 – In patients with previously treated multiple myeloma, the combination of thalidomide and high-dose oral dexamethasone with a 4-day infusion of cytotoxic chemotherapy is effective induction therapy before autotransplantation.
Under a protocol called DTPACE, a multicenter American team treated 236 myeloma patients with 4 days of dexamethasone and thalidomide and 4 days of continuous-infusion cisplatin, doxorubicin,
cyclophosphamide, and etoposide. All patients had previously been treated with at least 2 cycles of standard therapy, but 148 had shown progressive disease during therapy and 55 had chromosome 13
abnormalities.
Led by Dr. Choon-Kee Lee of the University of Arkansas for Medical Sciences in Little Rock, Arkansas, the researchers report their results in the July 15th issue of the Journal of Clinical Oncology.
According to the study, after 2 cycles of DTPACE, 32% of patients hadachieved partial remission, and 16% had achieved complete ornear-complete remission. The authors call this response rate "remarkable."
Higher response rates were observed in patients with high lactate dehydrogenase levels and in those who received 100% of the DTPACE dose for 2 cycles. Patients with chromosome 13 abnormalities responded as well as other patients, the investigators said.
"The combination of thalidomide with chemotherapeutic agents shows outstanding response rates in patients with myeloma who experience relapse after or are completely or partially refractory to standard chemotherapy," the authors write.
They added, "This study shows a significant therapeutic potential of
the DTPACE regimen and reveals a novel way of managing patients with
myeloma, especially those with high-risk features."[/quote]
Looks good to me… so I wish you all the best with it.:-) 😎
Dai.
Helen 12 years, 4 months ago.
