Pat Killingsworth Pat Killingsworth

“Half-life effect” and “therapy re-set”

Yesterday I explained how “the half-life effect” is nothing more than an oncology related rule of thumb.

I went on to add how when most cancers become drug resistant, even new, otherwise effective therapies tend to work for a shorter period of time–and how this  is especially true with multiple myeloma.

I have always been interested in this principle.  So this week, I took the time to ask both of my myeloma docs about how once relapse occurs following a stem cell transplant or long term maintenance therapy regimen, doctors in the know would only expect a remission to work for half as long.

Monday I asked my myeloma specialist–and the head of the BMT department at Moffitt Cancer Center, Dr. Melissa Alsina–about this.

As you might expect, we used my situation as an example.

After over four years on Revlimid, it became clear the drug was no longer working very well when my myeloma became active again and I relapsed.

Yet now, following my “failed transplant” (my words), Revlimid seemed to be working for me again.

This flies in the face of conventional wisdom.

So Dr. Alsina, how and why could this happen–and what about the “half life” theory of myeloma therapies?

Prior to undergoing my transplant, I asked Dr. Alsina what she thought about post-transplant reset;  how in theory, anti-myeloma therapies which were no longer working before a transplant might work again after.

“I have heard this theory.”  She replied.  “But I haven’t personally found it to be true…”

Fast forward eight months to our conversation Monday.  As we discussed my maintenance therapy options, I was surprised to hear Dr. Alsina bring-up the re-set affect.

“It looks like Revlimid is working again for you.”  She said.  “I think it would be a mistake not to include it in your maintenance regimen.” (after RVD either gets me back into remission, or plateaus over the next few months)

Lucky me!  My next stop was a Wednesday appointment with my local medical oncologist, Dr. Vikas Malhotra.

We discussed so many things during our 40 minute visit, I’m going to table the details until tomorrow or Monday.

But watch for several additional posts that I have been working on before then…

Feel good and keep smiling!  Pat