Almost all myeloma patients will experience relapse (the cancer returns after a successful course of treatment) and/or the disease will become refractory (the cancer does not respond to treatment). The choice of a treatment regimen at relapse is affected by many factors including the type of prior therapy, the number of previous lines of therapy and the aggressiveness of the relapse.
In some instances, the drug or combination of drugs that the patient had a good response to initially, may be repeated. Another option is to try one or more of the other therapies typically used in initial treatment. Other treatment options include:
- Bortezomib- and Lenalidomide-based Regimens such as
- VCD: bortezomib (Velcade®), cyclophosphamide (Cytoxan®), dexamethasone
- VTD: bortezomib (Velcade®), thalidomide (Thalomid®), dexamethasone
- VRD: bortezomib (Velcade®), lenalidomide (Revlimid®), dexamethasone
- Bortezomib and Liposomal Doxorubicin (Doxil®)
- Carfilzomib (Kyprolis®)
- Ixazomib (Ninlaro®)
- Thalidomide (Thalomid®)
- Pomalidomide (Pomalyst®)
- Panobinostat (Farydak®)
- Elotuzumab (EmplicitiTM)
- Daratumumab (Darzalex®)
- Selinexor (XpovioTM)
For information about the drugs mentioned on this page, visit Drug Listings.
The use of high-dose chemotherapy followed by autologous stem cell transplantation may also be an option for some relapsed/refractory myeloma patients, who have either not been treated with a transplant before or who had a good durable response to a prior transplant.
Many new agents being studied in clinical trials are also showing promising results in the treatment of relapsed/refractory myeloma. See Clinical Trials.
Download or order The Leukemia & Lymphoma Society's free booklet, Myeloma.