Lisa lyons

3. The ECOG trial that showed that lowering the dose of dexamethasone in myeloma saves lives. @TheLancetOncol 2010 Randomized trial that helped my career the most. Design proposed by a patient advocate! We didn’t realize the 10% mortality in the first year following diagnosis that occurred in newly diagnosed myeloma due to Dex related toxicity until this trial. The trial was done in a narrow population with doublet regimen. But the results were compelling and welcomed by patients and physicians alike that it became standard across the board with all regimens and all settings. @Rfonsi1 These type of randomized trials are only possible through @theNCI funded cooperative groups: @eaonc @SWOG @ALLIANCE_org Leadership of these trials requires investment of years participating in the group activities and perseverance. Also skill and effort because every word of the protocol and paper you have to write.

We stop all premeds (steroids, antihistamines, and acetaminophen) after cycle 1 for both IV and SQ dara. If someone has had reactions with even the last dose of cycle 1, then for that patient, these may be continued, but otherwise no.   Here is a paper on our experience.   ascopubs.org/doi/full/10.120…   2) Same DVT prophylaxis as you would do for Rev in any situation. No difference with or without Dex.