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Dr. Fritz van Rhee of UAMS Discusses The Multiple Myeloma Total Therapy Program - With A 40% Cure Rate for Low Risk Patients!

12/12/2013

Dr. van Rhree - Searching for the ultimate CURE!

Dr. Fritz van Rhee discussed the Total Therapy Program for Multiple Myeloma of the University of Arkansas for Medical Sciences (UAMS) in Little Rock, AR. The program was broadcast on December 16th, and you can listen to a rebroadcast of this exceptional Cure Panel if you CLICK HERE.

I am excited about this broadcast for a number of reasons. First, this is the only program in the world that has professed to a Cure for the last 10 years, and although they have been criticized for using the word cure, they now show a cure rate of 40% for low risk patients. This happens to be the best results of any hospital which reports their survival data. In addition, their most recent data shows an average life expectancy of 15 years for their TT3 program, and this is 3.8 times longer than the average of all the facilities that report their survival to the National Cancer Institute. Now some 10 years later many multiple myeloma specialists talk of cure in some 10 to 25 percent of myeloma patients. Second, Dr. van Rhee is not only a myeloma specialist he is one of the world's premier researchers into Castleman's disease (100 times rarer than myeloma). One of his patients honored him with one of the most moving stories of how a committed, relentless, caring, and patient driven doctor (Dr van Rhee), who refused to give up and saved his life. When he felt he was beyond death's door, with no more options available, the good doctor begged drug companies to give his patient one last chance. It truly moved me! You can read a Chicago Tribune article from his patient if you CLICK HERE. I was thinking I should photo shop a halo onto the head of Dr. van Rhee because he sounds like he should be Sainted. Finally, and for full disclosure, Dr. Bart Barlogie of UAMS along with Mayo Clinic saved my life from what was at the time a 3 month life expectancy for my myeloma which had a negative prognostic indicator. I am now 7 years and 10 months in CR with no sign of the MM in any of my tests.

UAMS is one of the most renowned and recognized programs in the world, and this broadcast is your opportunity to listen to one of the founding fathers of the Total Therapy program. To view a previous blog post about UAMS CLICK HERE. Good luck and God Bless your Myeloma Journey/ [email protected]

For more information on multiple myeloma CLICK HERE and you can follow me on twitter at: https://twitter.com/grpetersen1

Dr. van Rhee's brief Bio:

Fritz van Rhee M.D., Ph.D is an internationally known multiple myeloma researcher and professor of medicine in the UAMS College of Medicine and director of Developmental and Translational Medicine in the Myeloma Institute. He joined the Myeloma Institute in 2001, establishing a laboratory for developing innovative medical treatments using the bodys immune system. He is the leader of multiple National Cancer Institute-funded grant projects related to developmental therapeutics and anti-myeloma effects of so-called natural killer cells in the body's immune system. He earned his medical degree from the Erasmus University in Rotterdam, Netherlands in 1985 and is UK board certified in Internal Medicine and Hematology. van Rhee trained in Hematology and Bone Marrow Transplantation at the John Radcliffe University Hospital in Oxford and the Royal Postgraduate Medical School in London and earned his doctorate degree from the Imperial College of Science, Medicine and Technology at the University of London. He came to the U.S. in 1996 as a Fogarty Fellow under John Barrett, M.D. with the Allotransplant Section of the National Heart, Lung and Blood Institute at the National Institutes of Health.

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ASH 2013 - Multiple Myeloma from a Patient's and Myeloma Specialist's Perspective

12/8/2013

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Several of the members of the Multiple Myeloma Cure Panel were at ASH 2013 (American Society of Hemotology) and obtained the breaking news about myeloma treatment and care. They were part of a special ASH 2013 multiple myeloma review of the content from the meeting and they also answering listener questions. This is from the patients perspective, so it should be invaluable for the myeloma patient community. The meeting was broadcast on December 12th, and you can listen to the rebroadcast if you CLICK HERE.

You can view a presentation of ASH from a myeloma specialist's perspective if you CLICK HERE. Dr. Orlowski of MD Anderson and Dr. Richardson of Dana Farber, two of the most skilled myeloma practitioners in the world give you their takeaways from the meetings. Pat Killingsworth provided a blog post on this presentation and includes a lively discussion by his readers, and you can read it if you CLICK HERE.

Some of the biggest news that the panel members gleaned from the meeting include:

- They were all excited about the number of doctors who are now talking of CURE of low risk disease...in the next 5 years.
- Continued focus on Monoclonal antibodies like Daratumumab and SAR650984 which showed single agent results in heavily pretreated patients.
- Fit/Unfit/Frail categories for elderly
- SMM (Smoldering) Risk analysis & early treatment
- Cytoxin benefit over Melphalan
- So many treatment options now with Cfz and Pom and available clinical trials
- Maintenance still needs more study
- Buzz around Black Swan initiative and Onyx
- Maintenance vs. non-maintenance post transplant
- Top 8 new drugs - anti CD38, MLN9708, ARRY 520, ACY 1215, Selinexor, antiCD138, panobinostat, bendamustine
- Immunotherapies (daratumumab and CD138)
- Compass Trial
- Daratumumab, Revlmid, dex combination showed impressive results with a response rate of 73% in a small population of patients (8/11 patients who had received a median of 3-4 prior treatments)
- Novartis/Penn's customized T cell wows ASH with stellar leukemia data - A total of 19 of 22 pediatric patients with lethal cases of acute lymphoblastic leukemia experienced complete remissions after being treated with the CAR T therapy, CTL019, a T cell engineering to target cancer cells that express the CD19 protein. And they say it may have application for myeloma!

The one disappointment for me was the lack of any trials with an IMID, proteasome inhibitor, steroid, and monoclonal antibody such as RVd with Daratumumab.

Pictures of the Panel Members are shown below. Our own MYELOMA POWER RANGERS. Thank you so much for all you do for the multiple myeloma patient community.

Cynthia Chmielewski, Pat Killingsworth, Jack Aiello, Matt Goldman, Priya Menon, Lizzy Smith, Nick Van Dyk, Gary Petersen

Some panel members blogged daily from ASH. You can read Jack Aiello's posts if you CLICK HERE. Pat Killingsworth provided updates if you CLICK HERE, and Cindy Chmielewski blogged from ASH and you can read her updates if you CLICK HERE.

For more information on multiple myeloma CLICK HERE and you can follow me on twitter at: https://twitter.com/grpetersen1

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Multiple Myeloma - Why Do People Beat the Average Myeloma Life Expectancy Prognosis? Or How To Improve Your Mulitple Myeloma Survival Rate!

12/1/2013

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***This article was updated 9/24/2020 and you can read the update if you CLICK HERE.***
I published on this subject more than a year ago, and it has been very helpful to many in the myeloma patient community. I have provided some updates and hope that it helps to assist you in your myeloma journey.

The SEER(Surveillance, Epidemiology, and End Results) data for multiple myeloma has been published in 2013 by the National Cancer Institute, and the average life expectancy remains at 4 years for the third year in a row. However, some people beat the odds and live 10 to 20 years or more. When I was first diagnosed, the data for a person with dialysis-dependent kidney failure was just 3 months, and the overall average was 3 years. Now I am a 7 year and 10 month survivor, so I have beaten the average life expectancy prognosis at the time, and this was with what was called a negative prognostic indicator (kidney failure). So I believe you can break into two parts a patient's ability to beat the odds. Part one is disease dependent, or what was the hand that you were dealt. Part two is related to the level of care that is available to you. For more information on survival rates and life expectancy CLICK HERE.

Part 1 - Disease Dependent

Some people are just plain lucky and are given a form of myeloma that is not that aggressive. In other words they have myeloma, but it happens to be smoldering myeloma. This form of the disease can be present in the patient but not show any outward symptoms. It can remain in this mode for 5, 10, or even 20 years.

The age of the patient is very important, in that you are 2 times more likely to survive if you were diagnosed at 49 years of age or less. The average age of the typical myeloma patient is 70. You can read more on this subject if you CLICK HERE.

Some people may have an active disease but do not have any of the negative prognostic indicators. These include, but are not limited to, deletion of chromosome 17p and translocation of 4;14 or 14;16 or 14;20. Your myeloma specialist will run the FISH test or other genetic tests to determine if you have any of these negative prognostic indicators. If you are considered high risk, the life expectancy is just half of the current average, or just 2 years. You can read more about high risk multiple myeloma if you CLICK HERE.

The sensitivity of the disease to treatment is also important. My myeloma seemed to be very sensitive to the combination of Cytoxan, Thalamid and Dexamethasone and put me into remission very quickly. Some people might have the same experience with Revlimid, Velcade, or Dex, or any combination of these drugs. If the disease comes back, as it often does, the re-application of the same regimen may continue to work for years. I know one patient who has taken Thalomid for years as his only treatment and remains in remission. This is working well for him.

And of course if the average is 4 years, half of the people will invariably beat the average.

I am sure there are other disease factors, however, what I will discuss now is the part of disease control that you may or may not have more control over.

Part 2 - Quality of Care

There are some elements that you may or may not have much control over, the first of which is the availability of insurance. If you do not have insurance or have no access to care, the average life expectancy is less than one year. However, Medicare has a Compassionate Allowance Program where you can be approved in less than two weeks if you go to your local office and can show that you will not live without care. To see the program CLICK HERE. The Affordable Care Act may provide an option for the 15% who are not insured, and Medicare, Medicaid, and drug company assistance programs are also available. In addition, there are other programs which can provide assistance listed on the bottom of the home page, to view CLICK HERE. Unfortunately without care, like people who need dialysis (which is always covered by Medicare), you will have below average life expectancy.

An Experienced Myeloma Specialist SAVES LIFE! MAYBE YOURS!

Multiple Myeloma is a rare blood cancer, so many hematologist/oncologists may not see one patient in a year. As a result not all oncologists or hematologists are the same. However, some are very skilled and experienced with Multiple Myeloma and have treated many myeloma patients. The data shows these myeloma specialists provide an average life expectancy of 10 years or more, while the average remains stagnant at 4 years. For a listing of these exceptional specialists CLICK HERE or for a more extensive list without survival history just CLICK HERE. And obviously, if your myeloma specialist has an average patient life expectancy of 10 years, their patients will beat the average by more than twice the average. This is what I did when I chose to get my SCT(stem cell transplants) at University of Arkansas for Medical Sciences, UAMS, which has a myeloma program called MIRT, Myeloma Institute of Research and Therapy. At the time they had over 10,000 transplants under their belt, and as a result they were expert at the process, and knew what could go wrong and had a plan in place to get you through any potential complications. I have found from my work on this site that centers like Mayo, Dr. Hari(Medical College of Wisconsin), UAMS, or Dr. Berenson's (IMBCR) have very different approaches to treatment, but because they are expert in what they do, they have similar results. A brain surgeon is who you would choose over any other surgeon if you had a brain tumor, why would you not do the same for myeloma? Find out how to find a myeloma specialist by CLICKING HERE or CLICKING HERE .

Myeloma specialists have access to drugs that other oncologists do not. Because they are the thought leaders, they are involved in clinical trials, and can obtain some drugs through other programs that lesser known oncologists do not have access to. Worse yet, oncologists who are not myeloma specialists may not even know that some of these drugs even exist. For example, some of the well connected specialists have access to unapproved drugs like Daratumumab or Ixazomib through special programs. Or some specialists can use drugs that are only approved for relapse or secondary therapy options (Krypolis and Pomalyst), and obtain approval to use them for newly diagnosed patients. They also have access to the best clinical trials like VRD for first line therapy which provides a response in 100 percent of patients. When you run out of options with the currently approved drugs, they can provide access to those that have done great in clinical trial, but are not currently available to the general public. Because you need a significant infrastructure to conduct clinical trials at your facility and they cost the facility $15,000 per patient, few local oncologists have access to clinical trials. Sometimes it is who you know!

Myeloma patients seldom die from myeloma, they die from the complications from myeloma. The number one complication is pneumonia, and others include infections, kidney failure, anemia, etc. This, therefore, brings me to the realization that supportive care for the treatment of the many complications of this disease may just be as important as the cancer treatment itself. Or a great Defense(supportive care) is as important as the Offense(cancer therapy). MD Anderson and Mayo Clinic emphasize supportive care in their programs, UAMS actually has a Director of Supportive Care in their myeloma program, and Dr. Elias Anaissie, the Director of the Myeloma Program at the University of Cincinnati Cancer Center, has an extensive background in supportive care. Dr. Anaissie has published a well written example of an exceptional supportive care model. You can read this publication if you CLICK HERE. To read my blog post on supportive care CLICK HERE.

I also think the quality of care that you receive can also be affected by the knowledge of the patient, and this can be obtained by doing your research on finding the best approaches to care by looking at the work of the best myeloma specialists on-line, and by going to great sites as listed in the Resource Section of www.myelomasurvival.com. To find out how to get educated about multiple myeloma CLICK HERE. In addition, joining a support group of the International Myeloma Foundation or the LLS (Leukemia, Lymphoma, and Myeloma Society) will provide more great information to improve your life expectancy. I have found that the average life expectancy of most of these support groups far out-performs the average. Knowledge is power! Additional information on the benefits of support group membership can be found at if you CLICK HERE.

There are 80,000 multiple myeloma patients in the USA, and if we can move the average from 4 years to 10 years of life expectancy with the myeloma specialists, we could save 80,000 times 6, or 480,000 years of LIFE. Many times more if we include the entire world. You all can help by getting this message out to the myeloma patient community though Facebook and Twitter. Everyone knows someone who has myeloma or may have a friend or family member that can be helped by this information. With your help we can "SAVE LIFE"!

Good luck and God Bless your Myeloma Journey/ [email protected]

For more information on multiple myeloma CLICK HERE and you can follow me on twitter at: https://twitter.com/grpetersen1

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Dr. Fritz van Rhee of UAMS Discusses The Multiple Myeloma Total Therapy Program - With A 40% Cure Rate for Low Risk Patients!

ASH 2013 - Multiple Myeloma from a Patient's and Myeloma Specialist's Perspective

Multiple Myeloma - Why Do People Beat the Average Myeloma Life Expectancy Prognosis? Or How To Improve Your Mulitple Myeloma Survival Rate!

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