The New England Journal of Medicine – Becoming a Fan

I have discovered that The New England Journal of Medicine offers really neat 2 minute long quick take videos which summarise entire journal articles. As a private citizen I don’t have the luxury of journal access I once had. Articles can be 40 quid each.

NEJM allows you to register as private person and to download two articles per month free. It also lets you watch these videos. I am a fan, and no doubt will be back.

The results of the DETERMINATION clinical trial have recently been published in NEJM. “Triplet Therapy, Transplantation and Maintenance until Progression in Myeloma by P.G.Richardson et al.” In this people receiving lenalidomide, bortezomib and dexamethasone {RVD} either with or without high dose melphalan and autologous hematopoietic stem cells transplant are compared. There are benefits for progression free survival if you have the stem cell transplant.

The overall five year survival across all karyotypes looks to be ~80%

The wife has had daratumumab as well.

« Myélome multiple : DARZALEX (daratumumab), premier anticorps monoclonal anti-CD38

DARZALEX 20 mg/mL solution à diluer pour perfusion (daratumumab), est le premier anticorps monoclonal anti-CD38, un récepteur transmembranaire exprimé en grande quantité à la surface des cellules tumorales du myélome multiple.

Cet antinéoplasique hospitalier est indiqué dans la prise en charge du myélome multiple :

  • en monothérapie, en dernière ligne de traitement,
  • en association à une bithérapie (lénalidomide et dexaméthasone, ou bortézomib et dexaméthasone), en seconde ligne de traitement,
  • en association à une trithérapie (bortézomib, melphalan et prednisone) en première ligne de traitement chez les patients adultes non éligibles à une autogreffe de cellules souches. » 

There is no fully worked up trial to show if this new quartet therapy, followed by high dose chemo / stem cell transplant is better yet. But quartet is known to be better than triplet. She had it as a first line of treatment, which is relatively novel.

Recently a trial of Teclistamab , a B-cell maturation antigen and CD3 bispecific antibody is underway and in early phases looks promising as a means of treating refractory disease….This study is called MajesTEC-1.

So, it looks as though I am going to be keeping an eye on developments…

Hmnn..

Need to clear me swede now…that is quite enough for today…

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