Dear Dr. Berenson:

Do you think less than two cycles of Velcade without Dex is sufficient time to assess if Velcade alone will stop a plasmacytoma on the clavicle from growing when all other markers are in normal range? It has been suggested I add Doxil the 3rd cycle which I am hesitant to do due to the heart toxicity and losing my hair. (I have already had Doxorubicin with VAD before my auto SCT 3 years ago.) It has also been suggested I have a 2nd auto SCT. I think less is better and don't want to use up my drug options for down the road. Plus i wonder if I should add DEX before adding Doxil or try any of the other new combos like Velcade & Revlimid, et before going to Doxil? I'm not fond of having another SCT either with all the new options. I would just like your opinion on the options, I know you cannot act as a doctor prescribing treatment. Thanks so much for your guidance.

History:
Diagnosed Jan. 2005, age 50, Stage III IGG Kappa
VAD & Auto SCT July 2005 - CR
1st Plasmacytoma - lower jaw - Nov. 2006 - radiation
2nd Plasmacytoma - sternum - Jan 2007 - oral Revlimid 17 months - then started growing - radiated Aug. 2008 - growth indicated Revlimid no longer working although other MM markers normal - started Velcade Aug. 2008 - after 1st infusion of 1st cycle noticed 3rd plasmacytoma on clavicle - couldn't get last infusion of 2nd cycle due to low platelets - will get radiation and continue on Velcade (or Velcade with Doxil?).

Dear Faye,

Dr. Berenson isn't able to reply at this time, so I wanted to let you know.

Would your doctor be open to calling him for a consult? Have you called the IMF to talk about options?

Beth