NCCN Guidelines for Patients® | Multiple Myeloma - page 52

50
NCCN Guidelines for Patients
®
Multiple Myeloma, Version 1.2014
Chart 4.4.3
shows the recommended options for
additional treatment, which is given after previous
treatments have failed to kill all of the cancer or keep
it away. Additional treatment is recommended for
myeloma that didn’t respond to the primary treatment
or the stem cell transplant. It is also recommended for
myeloma that progressed or came back (relapsed)
after an initial treatment response.
There is a wide range of additional treatment options
to choose from. Primary treatment can be repeated
if it was completed more than 6 months ago. Other
options include chemotherapy alone, targeted therapy
alone, or combination regimens that may also include
steroids. If tests show progressive disease after any
of these options, supportive care is recommended.
Supportive care treats the symptoms of cancer and
the side effects of cancer treatment.
4
Treatment guide
Active multiple myeloma
Additional treatment
Preferred regimens
Repeat primary treatment if it ended >6 months ago,
Bortezomib,
Bortezomib/dexamethasone,
Bortezomib/lenalidomide/dexamethasone,
Bortezomib/liposomal doxorubicin,
Bortezomib/thalidomide/dexamethasone,
Carfilzomib,
Cyclophosphamide/bortezomib/dexamethasone,
Cyclophosphamide/lenalidomide/dexamethasone,
Dexamethasone/cyclophosphamide/etoposide/cisplatin,
Dexamethasone/thalidomide/cisplatin/doxorubicin/cyclophosphamide/etoposide + bortezomib,
High-dose cyclophosphamide,
Lenalidomide/dexamethasone,
Pomalidomide/dexamethasone, or
Thalidomide/dexamethasone
Other regimens
Bendamustine,
Bortezomib/vorinostat, or
Lenalidomide/bendamustine/dexmethasone
Chart 4.4.3 Treatment for relapse or progression
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