New drug option for treating myeloma

I’ve had a couple of conversations in the past week with Wellington’s Blood and Cancer Centre about the new availability of pomalidomide.

Read Pharmac announcement here

I am eligible, given that I relapsed last year and turned out to be refractory for lenalidomide. We had considered trying to get it under compassionate access or self-funding it, but as I had already had a mini-stroke (TIA) last year, we weren’t sure it was worth the clotting and stroke risk.

I’ve unexpectedly stabilised since December on a combo of Dexamethasone and four-weekly blood transfusions, so we’ve decided to give the pomalidomide a go.

Pharmac says it will be available from 1 August and that’s our target date to start. I’ll take it in conjunction with the current Dex regimen. (This is 20mg/day for three days, 12mg on day 4, and 8mg on day 5. Three weeks on with a week to recover in week 4.)

Apparently, 30% of people refractory to lenalidomide respond positively to pomalidomide. Those sound like good odds to me for trying something new.

We’re also told that we should see any positive result within 6 weeks to 3 months (2 to 3 cycles), which doesn’t seem too long to wait to decide whether to persist or pull the plug.

Feeling a mixture of enthusiasm about trying a new generation of a drug that might actually work, and apprehension about potential side effects, mostly clotting and even lower platelet numbers (currently in the 20s). I’ll probably need more frequent blood transfusions.

But, we don’t want to regret not taking the opportunity that might give me a few more months.