Our Total Therapy (TT) approach to treatment of multiple myeloma lies at the core of successful patient outcomes at the Myeloma Institute. The focus is on attacking myeloma on all fronts from the very beginning, applying a carefully crafted combination of available agents and treatment principles.
Starting in 1989 with Total Therapy 1, we have designed and conducted a series of clinical trials that have each built on lessons learned from the previous trials. Thus, Total Therapies 2 and 3 have seen advances in patient survival and complete response resulting from incorporating new agents and adjusting therapies to support the stem-cell transplants.
The transition from TT1 to TT2 introduced more intensive therapy before transplantation, as well as chemotherapy after transplantation, and TT2b also added thalidomide to the regimen. The transition to TT3 included thalidomide and added bortezomib.
By closely monitoring patients’ responses to each trial and conducting detailed analyses of individual patients’ disease characteristics, we have designed a progression of clinical trials that have shown steady improvements in patient outcomes. The graphs above show that the percentages of patients surviving and responding to therapy have increased as the trials have progressed from Total Therapy 1 to Total Therapy 2a, Total Therapy 2b, and Total Therapy 3.
Total Therapy treatment protocols that are currently enrolling patients include:
For previously untreated myeloma:
Total Therapy 4: A Phase III Trial for Low Risk Myeloma: A Randomized Trial Comparing Standard Total Therapy 3 (S-TT3) With TT3-Lite (L-TT3)
Total Therapy 5: A Phase II Trial for High-Risk Myeloma Evaluating Accelerating and Sustaining Complete Remission (AS-CR) by applying Non-Host-Exhausting and Timely Dose-Reduced MEL-80+VRD-PACE Tandem Transplants with Interspersed MEL-20-VTD-PACE and alternating V-RD AND M-RD Maintenance
For previously treated myeloma:
Total Therapy 6: Phase II Trial for Patients not qualifying for TT4 and TT5, Protocols because of Prior Therapy (no prior transplant)