Category: Pomalyst

Almost through cycle 8 of talquetamab / daratumumab / pomalidomide trial

I’m nearly finished with cycle 8.  For those of you who’ve asked, the side effects have remained the same throughout for me.  the situation with my nails has improved, though! They’re not peeling away from the bottom of the nail anymore.  Still, I have issues at the tops of the nails.  I have to keep them trimmed or they catch on things and tear.  They just seem really fragile, splitting and tearing without provocation.  The same thing happens to the nails on my toes.

My sense of taste hasn’t changed.  I still have little ability to taste certain things.  When I can taste something, it’s a bit different than what I’m used to.  For example, I can taste sweet things, but there’s an underlying bitterness to it. Some things have no flavor at all. I think I mentioned before that dill pickles have no taste.  Mustard is another thing I can’t taste.

I am still having difficulty swallowing.  I  always need to have water close by at meals to help me swallow certain foods.  Sometimes I take pills with yogurt, because that makes them easier to swallow.  I completely avoid some foods because they’re just too hard to swallow.

I still have a weird reaction to becoming too warm, whether it’s just the ambient temperature in a place (or outdoors), or I’ve exerted myself doing yard work or something else. What I experience is something I can only describe as being electrical shocks all over my head and upper body.  I described it to a friend who has MS, and she said that happens to her, too. She has the same sensitivity and reaction to heat.

Twice, since I started this treatment, I’ve had nausea and vomiting.  Usually, I have periods of time during which I feel queasy.  I take Zofran or compazine and usually feel better.  I  haven’t decided which works best for me.

I still have dry mouth issues.  The only concern I have about that is how it’s affecting my teeth.  I’ll see the dentist on Monday and will find out if anything’s changed in the last 6 months.

Every Other Week!

I was just told today that, starting with cycle 9, I’ll be moving to an every other week treatment schedule.  That’s amazing news.  The weekly treatment schedule has been trying.  I also found out that I had been getting daratumumab just once a month with cycle 8.  I hadn’t realized it, but was thinking I had just lost track of when I was getting it. I am looking forward to seeing how the reduction in frequency of administration will improve the side effects I’ve been experiencing.

One thing that will happen, though, is that my talquetamab dose will be increased to make up for the change in schedule. Early on, I experienced acute pancreatitis from talq.  My dose right now is something like a quarter of the original dose,  I’ll have to come in for labs in the weeks between treatment just to make sure my pancreas is ok.

One of the staff here told me that they know of a patient who had to drop out of the trial for some reason, and that this person had been free of any treatment for 8 months since then.  That’s encouraging. It would be nice if this drug could give us some time away from treatment at some point.

Masks

I walked into the cancer center this morning and saw someone with his mask pulled down below his nose and someone else with no mask on at all.  Someone else had their mask pulled down to their chin. I realize that nobody wants to have the mask police job, but this is the cancer center. There was a volunteer, clinical staff, and security right there.  How can patients and visitors not understand how important it is to protect themselves and others by properly wearing a mask?  I’m so disappointed.

I bought a shirt with this graphic.  I wish I’d worn it today.

Cycle 4 of talquetamab and daratumumab

I’m in cycle 4 now.   I still go every week for treatment, but here’s something to look forward to:  At the end of cycle 6, I’ll have a PET scan.  If everything looks good on the PET scan, my treatment schedule will change to every other week.

My Pomalyst dose has been decreased to 2 mg/day.  It’s been noticeably easier to tolerate than 3mg.

I am getting daratumumab every other week now.  I’m still getting talquetamab every week.

 

Dose Reductions

This’ll be quick.  My talquetamab and Pomalyst doses have been reduced due to the effects on my pancreas.  I started a few weeks ago on 4 mg of Pom.  Now I’m taking 3 mg.  Talquetamab was administered at 400 micrograms/kg, and now I’ll be getting 135.  I was feeling as though I’d had a punch in the gut, and my lipase results were elevated. A CT scan didn’t reveal any pancreas disease, but the study team decided it’s better not to allow it to get that far.

One of the RNs told me that MANY people have trouble tolerating Pomalyst.

I had Zometa today, too.

I’ll post some test results next time.

Celegene REMS Has An App

It’s been a while since I took Pomalyst or Revlimid.  I used to have to make a call to Celgene to take a survey.  The purpose of the survey is just to make sure patients are aware of the safety concerns.  I just got a call from the cancer center pharmacy that I can pick up my pom prescription when I go in on Thursday, as long as I’ve completed my survey.  I searched for the online survey, and found out that they have an app now!  It will remind me when my next survey is due.

The starting dose for pom is 4 mg per day, for 21 days.  Since I’ve had it before, I already know there’s going to be a dose reduction in my future.

Daratumumab, Pomalyst & Talquetamab Trial

I’ve signed consents and started testing for a new trial using daratumumab (dara), pomalyst (pom) & a new drug called talquetamab.  The one thing I have left to do is the bone marrow biopsy, which will be done next Thursday.  Here’s a link to the info about the trial.

https://clinicaltrials.gov/ct2/show/NCT04108195

I’ve had another PET scan since I last posted, and a few spots have gotten worse.  It’s disconcerting. But, I hope the trial drugs will stop the myeloma and give me time to wait for some more treatments to come down the pipeline.  This is different for me, because I’ve never had bone issues before & I assumed I never would.  There’s some pain associated with it, especially in my spine and left hip.

I’ve had dara and pom together before, but just briefly.  Daratumumab is also known as Darzalex®.  This version is called DARZALEX FASPRO®.  Is it supposed to be all caps, or is Janssen shouting at me?  The reason this version of the drug is different, is that it’s given as a subcutaneous injection, rather than by IV (which is how I had it some years ago).  We must remember to the ® when we write about daratumumab by its brand name. ; )

This trial requires a hospital stay of up to 10 days.  The reason for that is that the injections can cause cytokine release syndrome (CRS).  I had grade one CRS when I had my first infusion of the Teneobio drug in the last trial/treatment.  I’m expected to have that again, and one doctor told me the second injection will be worse than the first. I’ll be on the BMT unit, which has nice rooms. I hope I’ll have a nice view!

Speaking of nice views, these are some Carolina Chickadees I saw in the back yard a few days ago.


I’ll let you know how everything goes.

Carfilzomib and Cytoxan

Well, the daratumumab and pomalyst train has left the station without me.  My doctor decided that it wasn’t helping me anymore, so I’ve moved on.

A few weeks ago I started carfilzomib (Kyprolis) and cyclophosphamide (Cytoxan).  I also have 20 mg of dexamethasone every week. I have carfilzomib on Thursdays and Fridays and Cytoxan only on Thursdays.  I’ll have three weeks on, then one week off.  So far, my CBCs are pretty good.  I have only slightly low hgb, rbc and platelets.  Those were all low most of the time before this, anyway, so that’s nothing new.

As soon as I have some test results to post, I’ll do that.

If you’ve been on this treatment, I’d like to hear from you.

 

Still on Darzalex

This is just a quick update.  I’m still on Darzalex, but am also taking 2 mg of Pomalyst (pom) 21 days a month.  I’m not taking dex at the moment.  I just get 20 mg of dex with each dara infusion. We’ll see how that goes.

For the last 3 or 4 months, I’ve been getting dara via rapid infusion.   That cuts down on a lot of chair time. It feels like I may be having some more pronounced side effects from the rapid infusion in the form of fatigue and a bit of just feeling yucky.  I asked my doctor if he’s heard others say they feel a little worse after the rapid infusion, and he said that seems to be the case with some people.

Anyway, I am still alive and am stable at this point.

dara = daratumumab
pom = pomalidomide