Navigation Links
Drug combination effective against multiple myeloma, researchers show
Date:11/21/2007

HOUSTON - Pairing a new thalidomide derivative with a steroid slows progress of multiple myeloma, an incurable bone marrow cancer, and prolongs the lives of patients who have relapsed from previous treatment, researchers report in the Nov. 22 New England Journal of Medicine.

In the study conducted at 44 centers in the United States and Canada, 353 patients with myeloma received either a combination of lenalidomide (Revlimid(r)) and the steroid dexamethasone or dexamethasone plus a placebo.

"Those taking the lenalidomide combination had a median time to disease progression of 11.1 months compared with 4.7 months in the placebo-dexamethasone group and an improved median overall survival time of 29.6 months compared with 20.2 months," says lead author Donna Weber, M.D., associate professor in the Department of Lymphoma and Myeloma at The University of Texas M. D. Anderson Cancer Center.

The results were impressive enough that in December of 2005 an independent interim data analysis resulted in the trial being halted early so those on placebo-dexamethasone could also benefit from the addition of lenalidomide.

The collaborative study by North American Multiple Myeloma Study Investigators, and an international trial also reported in the New England Journal of Medicine, led to the approval of lenalidomide and dexamethasone for previously treated patients by the U.S. Food and Drug Administration in 2006.

"These trials highlight how large-scale cooperation in a team effort by myeloma investigators can quickly confirm benefits and introduce new active agents for patients with this disease," Weber says. "We also owe a debt to the willing patients who participated in this study."

Multiple myeloma is caused by formation of abnormal plasma cells, a type of white blood cell, in the bone marrow. These cells multiply rapidly, crowding out normal red and white blood cells and platelets. Tumors starting in the bone marrow may cause pain, and weaken bones predisposing them to fracture. In the United States about 20,000 people are diagnosed with multiple myeloma annually, and about 11,000 succumb to the disease each year.

Thalidomide, a breakthrough drug for multiple myeloma, is produced and marketed by Celgene Corporation as Thalomid(r). The company chemically altered thalidomide to make lenalidomide, known commercially as Revlimid(r), in hopes of reducing side effects and improving efficacy against the disease. The drugs attack both the malignant cells and the cellular environment that nurtures them.

Of 177 patients who received the lenalidomide combination therapy, 108 (61 percent) had complete, near-complete or partial responses to the medication compared with 35 patients out of 176 (19.9 percent) in the placebo-dexamethasone group.

An analysis by Michael Wang, M.D., assistant professor in the Department of Lymphoma and Myeloma at M. D. Anderson, found 56.8 percent of patients who had prior treatment with thalidomide before receiving the lenalidomide combination had a response, compared with 64.1 percent with no previous thalidomide treatment. "That suggests that the drugs differ enough to get a separate response, not just a refinement of side effects," Weber says.

The superior results for the combination also held up among patients previously treated with another new drug, bortezomib, a proteasome inhibitor known commercially as Velcade and marketed by Millennium Pharmaceuticals.

Combinations of drugs are important in ongoing treatment as a patient's disease becomes resistant to one therapy. "It's great that this research gave us a new drug," Weber says, "But what we also find with new drugs is that they work well with older therapies, which gives us many combinations to offer our patients."

Lenalidomide is being tested as a front-line therapy and in combination with other medications in a variety of clinical trials.

Overall, 85.3 percent of those receiving the combination therapy experienced side effects compared with 73.1 percent of the placebo-dexamethasone group. Some of the side effects were serious enough to cause 19.8 percent of the combination group and 10.2 percent of the placebo group to quit the trial.

Major side effects from the combination were suppression of patients' white blood cells, making them vulnerable to infection, and formation of blood clots. In most cases, these side effects were countered by decreasing the lenalidomide dose, or administering antibiotics or anticoagulants.

One of the major side effects of thalidomide - significant nerve pain and numbness in the limbs known as peripheral neuropathy - was nearly absent in the lenalidomide group.


'/>"/>

Contact: Scott Merville
sdmervil@mdanderson.org
713-792-0661
University of Texas M. D. Anderson Cancer Center
Source:Eurekalert

Related medicine news :

1. Promising drug combination may help those with ocular melanoma that has spread
2. Combination therapy reverses effects of portal hypertension in rats
3. Combination vaccines okay for infants, study shows
4. Antidepressants and painkillers - a dangerous combination
5. Intra-arterial combination chemotherapy induces long-term survival for hepatocellular carcinoma
6. U.S. Oncology Initiates Complete Phase Ib Trial of Brostallicin Combination Therapy in Advanced Solid Tumors
7. Drug combination might offer hope for patients deadly brain tumors
8. EpiCept to Present Preclinical Studies of EPC2407 in Combination With Anti-Angiogenic and Chemotherpeutic Agents at the AACR-NCI-EORTC International Conference
9. Combination targets: some drugs may work best when they work together
10. MAP Pharmaceuticals Initiates Phase 2a Clinical Trial of Combination Therapy in Adult Patients with Asthma
11. Quality Control: Nissan Quest to Feature micronAir(R) Combination Cabin Air Filters
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/6/2016)... ... February 06, 2016 , ... Research has shown that building ... the frequency and level of relapse. , At the 2016 iaedp ... will explore the critical tasks of the recovery phase and beyond including relapse ...
(Date:2/5/2016)... , ... February 05, 2016 , ... Love is in ... in a variety of colors, assortments and packaging. This staple for Valentine’s Day is ... Kullen location. , For Valentine’s Day, not only are long-stem roses available, but ...
(Date:2/5/2016)... City, UT (PRWEB) , ... February 05, 2016 , ... ... Whole-Food Nutrition , announced that the much-anticipated feature with author Jahnavi Foster, specialist in ... Humans Amateur TV Network. , Each week, on his weekly Whole-Food Warrior TV show, ...
(Date:2/5/2016)... ... February 05, 2016 , ... The event is being held ... Event Center in Minneapolis, Minn. Triumph Over Parkinson’s will fund nearly $100,000 for research ... Schneiderman’s Furniture, lives with Parkinson’s disease and is the architect of this informative event ...
(Date:2/5/2016)... ... February 05, 2016 , ... Francisco Canales, ... services in their Napa Valley office. The technique utilizes the body’s own healing ... Canales and Dr. Furnas, are part of only a select few cosmetic surgeons ...
Breaking Medicine News(10 mins):
(Date:2/4/2016)... LONDON , Feb. 4, 2016 ... Summary Global Markets Direct,s, ,Wegener Polyangiitis - ... the Wegener Polyangiitis,s therapeutic pipeline. This report ... Wegener Polyangiitis, complete with comparative analysis at various ... action (MoA), route of administration (RoA) and molecule ...
(Date:2/4/2016)... LONDON , Feb. 4, 2016 ... and competitive market to drive long-term market growth ... very common set of chronic disorders that affect ... disparate in terms of their symptoms and key ... by dysregulation of immune pathways and an inappropriate ...
(Date:2/4/2016)... COLUMBUS, Ohio, Feb. 4, 2016 Mettler-Toledo International ... results for 2015.  Provided below are the highlights: ... the quarter compared with the prior year.  Reported sales ... in the quarter. , Net earnings per diluted ... in the prior- year period.  Adjusted EPS was $4.65, ...
Breaking Medicine Technology: