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New Research Demonstrates Advances in Optimizing Treatments and Quality of Life for People With Hard-To-Treat Forms of Blood Cancer
Date:12/5/2009

el agents such as thalidomide, bortezomib, and lenalidomide. According to results from the Velcade as Initial Standard Therapy in Multiple Myeloma: Assessment With Melphalan and Prednisone (VISTA) trial, the combination of bortezomib, melphalan, and prednisone is significantly superior to melphalan and prednisone alone, which has been the current standard of care for multiple myeloma patients who cannot receive a stem cell transplant. However, research has not yet confirmed whether an alkylating agent (chemical compound) or an immunomodulatory therapy (drug that suppresses or stimulates the body's immune response) is the optimal partner for bortezomib. Researchers from the Spanish Myeloma Group designed a study to better determine if melphalan or thalidomide should be used as part of induction therapy (the initial treatment given to patients) in combination with bortezomib. The study showed that elderly patients were able to receive less aggressive treatment regimens of induction therapy by supplementing them with a maintenance treatment.

In order to evaluate whether the induction therapy regimen could be further optimized by decreasing toxicity while maintaining efficacy, the intensity of both treatment regimens was reduced as compared with the VISTA regimen, but supplemented with maintenance therapy. In this study, 260 patients with a median age of 75 years were randomized to receive a modified induction schedule of six cycles of bortezomib, melphalan, and prednisone (VMP) or bortezomib, thalidomide, and prednisone (VTP) as induction therapy followed by maintenance therapy with bortezomib and thalidomide (VT) or bortezomib and prednisone (VP) for up to three years.

Study results indicate that modified induction schedules for both VMP and VTP were highly effective with similar overall response rates (80 percent for VMP and 81 percent for VTP), which were determined using the European Group for Blood and Marrow Transplantation (EBMT) criteria
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SOURCE American Society of Hematology
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