Topics:
Hematologic Malignancies • Medical Oncology • Myeloma • NCI-CCC Tumor Board Question • University of Washington • NCI-CCC Myeloma Tumor Board Question • Multiple Myeloma
Do you resume zoledronic acid or denosumab at relapse in multiple myeloma?
Previous questions have focused on the newly diagnosed setting and choice of bisphosphonate versus denosumab. IMWG guidelines do recommend resuming zoledronic acid at subsequent relapses - do you?
Answer from: Medical Oncologist at Community Practice
This is generally a data free zone. Remember at induction, the overall survival benefit with Zometa is ONLY in patients with myeloma bone disease achieving less than a partial response to induction. The skeletal related event (SRE) risk reduction compared to placebo was dependent on myeloma con...
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Answer from: Medical Oncologist at Community Practice
The impact of response on survival was based on post-hoc analysis of the UK Myeloma IX trial. Methodologically speaking, when facing a decision whether to act based on the original randomization vs. post-hoc subgroup analysis, it is usually safer to stick to the original allocation.