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Thalidomide Improves Outcomes for Older Myeloma Patients

Adding the drug to standard chemo boosted survival, study found

FRIDAY, Oct. 5 (HealthDay News) -- Elderly patients with multiple myeloma live longer when thalidomide is added to standard combination chemotherapy treatment, a new study finds.

The finding could be the first real treatment advance for these types of patients in decades, the researchers said.

Standard chemotherapy for elderly patients involves two drugs, melphalan plus prednisone, explained a French team who are publishing their findings in this week's issue of The Lancet medical journal.

The study included 447 previously untreated patients, ages 65 to 75, divided into three groups: 196 received melphalan and prednisone (MP); 125 received MP plus thalidomide (MPT); and 126 received reduced-intensity stem cell transplantation using melphalan (MEL100).

Median survival times were: 33.2 months in the MP group; 51.6 months in the MPT group; and 38.8 in the MEL100 group.

MPT patients were 41 percent less likely to die than MP patients and 31 percent less likely to die than MEL100 patients.

"Our study has shown that the addition of thalidomide to standard melphalan and prednisone significantly extended survival for elderly patients with previously untreated multiple myeloma," wrote a team led by Dr. Thierry Facon, of the Centre Hospitalier Universitaire de Lille. "We noted that the MPT regimen was better than the MP regimen in terms of response, including complete response, overall survival, and progression-free survival."

The researchers concluded that the results "provide strong evidence to suggest that the MPT combination, should, at present, be the reference treatment for previously untreated elderly patients with multiple myeloma. After 40 years of unsuccessful attempts to find a more effective treatment than the standard MP, the MPT combination opens an era of progress for elderly patients with the disease."

Two experts who weren't involved in the study agree. In an accompanying Lancet Comment, Dr. Antonio Palumbo and Dr. Mario Boccadoro wrote that "we now have extensive evidence to support the introduction of MPT as the standard of care for elderly patients with multiple myeloma."

More information

The American Cancer Society outlines treatment options for multiple myeloma.

-- Robert Preidt

SOURCE: The Lancet, news release, Oct. 5, 2007

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