Celgene Corp. announced on January 9, 2006, that the Phase III trial of its drug Thalomid (thalidomide) was stopped early after the drug was shown to dramatically limit the progress of multiple myeloma, a blood cell cancer. Among the 270 individuals enrolled in the trial, those who were treated with Thalomid and dexamethasone had a slower progression of their disease (average 75.7 weeks) than those treated with dexamethasone alone (average 27.9 weeks). Although not approved for use in the treatment of multiple myeloma, Thalomid is already the most widely-prescribed drug for treating the disease.
Cyclophosphamide and prednisone effective for relapsed MM after transplant
University of Toronto researchers investigated the efficacy of, and ability of individuals to tolerate, weekly oral cyclophosphamide in combination with alternate-day prednisone for relapsed multiple myeloma after autologous stem cell transplantation. The researchers found that 61% of the 59 individuals evaluated responded to the treatment, including 24 with a partial response lasting a median 20.9 months and 12 individuals with a minor response. The researchers estimate the median overall survival from the time of treatment initiation at 28.6 months. The one-year overall survival rate was 83%. Most individuals tolerated the treatment well. The research was published in the December 2005 issue of Mayo Clinic Proceedings.
Low-dose aspirin reduces dangerous blood clots in MM treatment
Another study published in the December 2005 issue of Mayo Clinic Proceedings looked at the effects of giving daily low-dose aspirin to prevent blood clots (venous thromboembolic events, or VTEs) in individuals with multiple myeloma who were receiving doxorubicin (Adriamycin), vincristine (Oncovin), and decreased-frequency dexamethasone, plus thalidomide (DVd-T). The researchers found that daily low-dose aspirin (81 mg orally) given to individuals with newly diagnosed or relapsed/refractory multiple myeloma who were receiving DVd-T reduced the incidence of VTEs without an increase in bleeding complications.
High-dose therapy increases remission in MM but does not extend survival
Researchers at the Hospital Clinic in Barcelona studied individuals with multiple myeloma to see if high-dose therapy would affect remission and survival rates. The researchers randomized 164 individuals who had responded to initial chemotherapy to an additional 8 cycles of the same regimen, the regimen intensified with melphalan (Alkeran), or the regimen plus melphalan and total body irradiation. Six months after the treatment ended, 30% of individuals who underwent high-dose therapy (HDT) intensification showed a complete response, compared with 11% of individuals who received standard therapy. Progression-free survival was 42 months with HDT versus 33 months with standard therapy. Overall survival was 61 months with HDT and 66 months with standard therapy. Survival after relapse of disease was the same in both groups, about 16 months. Further research needs to be done to see if adding other drugs to HDT would make it more effective. The research was published in the December 1, 2005, issue of Blood.
Last updated 2/6/06
Information for this article was taken from:
- Celgene Corp. Press release, dated 1/9/06.
- Trieu, Y., et al. (2005). Weekly cyclophosphamide and alternate-day prednisone: An effective, convenient, and well-tolerated oral treatment for relapsed multiple myeloma after autologous stem cell transplantation. Mayo Clinic Proceedings, 80, 1578-1582.
- Baz, R., et al. (2005). The role of aspirin in the prevention of thrombotic complications of thalidomide and anthracycline-based chemotherapy for multiple myeloma. Mayo Clinic Proceedings, 80, 1568-1574.
- Blade, J., et al. (2005). High-dose therapy intensification compared with continued standard chemotherapy in multiple myeloma patients responding to the initial chemotherapy: long-term results from a prospective randomized trial from the Spanish cooperative group PETHEMA. Blood, 106, 3687-3688.
