I just want to cover one other area before we wrap up. Dr. Lonial, we got a lot of questions in about side effects, and we talked about new ways of giving bortezomib or Velcade, subcu, for example, or maybe a newer generation proteasome inhibitor, carfilzomib, that might have fewer side effects. It’s very much on the minds of people. Jack, I know you’re happy to be with us 16 years after being diagnosed, but had side effects for sure. Dr. Lonial, what do you tell people on how we can try to help them fight their myeloma but improve their quality of life and not be debilitated with side effects?
Yeah, I think that that’s a really important point. And, you know, when we were dealing with a disease that had a very limited number of treatment options and the median survival was shorter, you know, 10 or 15 years ago, I think that whatever drugs you did have you used them until--the main focus was disease response, how patients felt during treatment was not as important because you just didn’t have that much that you could do.
When we think about myeloma patients now we think about a 10- to 15-year course for many of them, and so I think it is important that we minimize the number of long-term side effects they have. And one way to do that is to, even for instance if you’re receiving a drug like bortezomib or Velcade, if in the middle of the cycle you start having trouble with a numbness in your fingers or on your hands or something along those lines it’s okay to let the nurse know that early on so that dose adjustments or modifications can at least be considered. And that doesn’t mean that you want to do that or that you have to do that, it just means that it’s something that should be actively thought about.
And the same for drugs like thalidomide or Revlimid. If there are side effects or things that are occurring let your doctor or the nurse know about them so that we can try and minimize long-term complications because long-term complications are going to be what keeps coming up over and over again, and ultimately may limit your ability to receive new drugs in trials. If you’ve got bad neuropathy you’re not eligible for many clinical trials anymore, and that doesn’t mean that you can’t get treated with these new drugs, but not only does it impact your quality of life but it ultimately may impact your life if you can’t get some of these new lifesaving agents. So I would say pay attention to these side effects. Let your doctor and the nursing team know about it so that we can prevent them or minimize them from limiting quality and quantity of life.