The goal of the RVDD trial that I am participating in (got the last spot!) is to prove scientifically the effectiveness of a four drug combination (Rev, Velcade, Dex, Doxil). Thanks to all the new MM friends I have connected with through this blog and Facebook I have learned that today's standard (or most common practice) to treat Multiple Myeloma is using Revlimid, Velcade and Dex (steroid)...commonly known as RVD. Depending on the age, effectiveness of the chemotherapy, patients may then move to transplant (most like auto, i.e. your own cells) and some docs are pushing a tandem (back to back) bone marrow transplants in hopes for an even deeper remission.
So there's some background, now on to the results after completing Cycle 3 of 4 (or maybe 5 and 6). I have another graph for you! This time I have charted the M-Protein (a.k.a. M-Spike)that has been floating in my blood for the last 16 months. The goal with any chemotherapy or transplant is to knock down the M protein to zero. M-protein is a key marker for MM and a normal Joe has zero. The thought is that if you can get rid of the M-protein and it doesn't return after 5-6 years...maybe it won't return. That's the game winning kick we are going for...a deep remission and possibly a Cure.
Since starting treatment my M protein has been on the following decline:
Cycle #1: 1.9
Cycle #2: 1.2
Cycle #3: 1.0
Cycle #4: TBD
I learned on my last visit with Dr. J that a GPR (Good Partial Response) is 50% reduction in the M Protein. Hooray...I got there after Cycle #2! To achieve VGPR (Very Good Partial Response), my M protein will need to reduce to 0.3. I think the staff (and me) would like to see VGPR before moving onto bone marrow transplant (BMT). Research is showing that the more you can kick the M protein to the ground, the better long term results. The transplant should whack any remainder M protein, but I would prefer we whack it down with chemo prior to transplant to ensure the bad guy is gone post-transplant.
So what this means is that they may actually pull my stem cells after Cycle #4 (while my bone marrow is still doing okay) and then move on to a 5th and 6th Cycle of RVDD to continue to kick away in hopes to get that M-protein as low as possible; if not gone. I am in agreement with this approach. I don't want to rely on my transplant (or two) to bring down the M protein when we can continue to kick its butt with RVDD.
On a side note...I am sporting a beard and I like it. In a few weeks I will be dying my hair in anticipation of my transplant. This is my one opportunity to go from middle class, midwestern Alltel look-a-like to Rockstar/Poser. Isn't cancer great?!?