Best Treatments for Relapsed Multiple Myeloma Patients

Brought to you in partnership with the Multiple Myeloma Research Foundation

If you have recently had a multiple myeloma relapse, hope is not lost. You can still have a favorable outcome. There are many effective treatment options for relapsed or refractory patients and even more, options are now being tested in clinical trials. 

Once patients have achieved a response (decrease in disease burden and decreased signs and symptoms of myeloma) with front-line therapy (induction, stem cell transplant and maintenance), they are closely followed by their care teams to watch for signs of relapse (loss of response to their current drug regimen) and reappearance of myeloma signs and symptoms.

What if you have a relapse? There are a number of treatment options for patients experiencing their first relapse that may depend on disease factors. In some cases, patients may require an aggressive form of treatment. The choice of your next therapeutic option may rest on when your relapse takes place. The best treatment plan requires finding the right treatment center and team. Luckily, the Multiple Myeloma Research Foundation (MMRF)’s find a treatment center tool can help you find a cancer center that has already developed its own treatment guidelines for relapsed patients.

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A small percentage of patients, particularly those with high-risk diseases, do not respond well to front-line therapy. These patients may respond well to the front-line therapy at first, but may later relapse. Other patients may relapse during maintenance or continuous therapy or after completing their first treatment regimen.

Your therapy choices may depend on when your relapse occurs.

Therapy choices for a first relapse that occurs less than 6 months after front-line therapy:

• Different therapy
• Autologous stem cell transplant
• Clinical trial

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Therapy choices for a first relapse that occurs more than 6 months after front line therapy:

• Repeat initial therapy
• Different therapy
• Autologous stem cell transplant
• Clinical trial

Due to the research conducted in clinical trials, second-line therapy has proven to be successful in providing longer periods of remission and longer life in patients.

Therapy choices for second-line therapy may include the following drugs in combination with a steroid (dexamethasone or prednisone):

• Velcade
• Revlimid
• Kyprolis
• Empliciti
• Ninlaro
• Darzalex

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If an early response is not achieved with a second-line combination therapy, or when a patient has a relapse from second-line therapy, a third drug may be added:

• Pomalyst
• Farydak
• Sarclisa
• XPOVIO

As a relapsed or refractory patient, you may also consider participating in a clinical trial. There are many new agents and immune therapies under investigation, which may provide treatment benefits to relapsed/refractory patients. Your care team can help you find an appropriate trial. You can also use MMRF’s clinical trial finder or speak with an MMRF patient navigator for more information.

Remember, a relapse is not a reason to lose hope. You may have other options for new therapies, from proven options to new clinical trials. Talk to your care team and use the MMRF resources to help you find answers and options to deal with your relapse.