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Cesar A. De Las Casas, MD, MPH, board-certified hematologist and oncologist. He earned his medical degree from the Universidad Peruana Cayetano Heredia in Lima in 1994. He completed his internship in internal medicine at the Baylor College of Medicine in 1999, serving as Chief Medical Resident at St. Luke’s Episcopal Hospital in Houston and at Ben Taub Hospital in 1999 and 2000.
GRACE sat down with Cesar A. De Las Casas, MD, MPH, to discuss information regarding if there a preferred induction therapy (¿¿Hay alguna terapia de inducción preferida?). Stay tuned for more on our continuing video series with our Spanish speaking faculty on updates in blood cancer treatments, and Multiple Myeloma, (Mieloma Múltiple).
Transcription:
¿Hay alguna terapia de inducción preferida?
El tratamiento del mieloma múltiple debe de ser individualizado y centrado en las características del paciente, en la presencia o no de otras enfermedades, comorbilidades, las características citogenéticas y moleculares. Todas estas características van a ser importantes para diseñar el tratamiento inicial o de inducción para estos pacientes.
Existen distintos esquemas de categorización o de riesgo bajo, intermedio o alto que permiten al clínico presentar al paciente distintas opciones. El caso más usado en Norte América es la combinación de bortezomib que es un inhibidor de proteosoma con ciclofosfamida y dexametasona. También se usa la combinación de bortezomib con lenalidomida y dexametasona.
Estos esquemas son comparables y van a ser las combinaciones más frecuentemente usadas, no siendo las únicas. Hay otras combinaciones de 2 fármacos como bortezomib y dexametasona, o lenalidomida y dexametasona, pero estos van a depender de las características particulares de cada paciente y la firma molecular y a nivel citogenético.
Mieloma múltiple cada vez se considera más como un grupo de enfermedades que una sola enfermedad que se puede encasillar en un solo tratamiento.
Is there a preferred induction therapy?
The treatment for multiple myeloma needs to be personalized and patient-centered, it has to be based on the presence or absence of diseases, comorbidities, cytogenetics and molecular characteristics. All these characteristics will be important to design the initial or induction treatment in these patients.
There are several schemes that categorize based on the low, intermediate or high risk, that allow us to be ready with many options for the patient. The most used case in North America is the combination of bortezomib, a proteasome inhibitor, with cyclophosphamide and dexamethasone. We also use the combination of bortezomib with lenalidomide and dexamethasone.
These treatments will be the most used, but they are not the only options. There are other combinations of 2 drugs like bortezomib with dexamethasone or lenalidomide and dexamethasone, but these combinations depend on the particular characteristics of the patient, and their molecular and cytogenetic characteristics.
Multiple myeloma is now considered as a group of diseases, and not as a single disease that can only use one treatment.
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