New Multiple Myeloma Treatment Scheme Doubles Survival Rates

New Multiple Myeloma Treatment Scheme

Researchers at the University of Chicago Medical Center have found that triple therapy, carfilzomib-lenalidomide-dexamethasone  can double the survival rates of patients with multiple myeloma. Researchers said such patients had a durable response compared with those treated with standard therapy.

Multiple myeloma is a cancer of blood cells, specifically white blood cells. Multiple myeloma is one of the most common hematological cancers, and the average survival ranges between 3 and 4 years from diagnosis for patients treated with conventional therapy. Multiple myeloma affects men more than women and the age at which it commonly occurs is 65-70 years. Recently it was found that multiple myeloma appears to affect increasingly younger ages. There are four specific paraclinical features of multiple myeloma:  high serum calcium levels, kidney failure, anemia and pathological bone fractures. These symptoms appear as a result of accumulation in the bone marrow of abnormal blood cells that interfere with normal production of blood cells.

Therapy consists of chemotherapy, stem cell transplantation and radiotherapy. Steroid durugs are also used, immunomodulatory drugs, proteasome inhibitors, etc. Radiation therapy is used for pain relief caused by the bone lesions, but it can also kill cancerous cells. Standard treatment includes bortezomib, a proteasome inhibitor, thalidomide, lenalidomide. As far as chemotherapeutic drugs are concerned, most commonly used are melphalan, cyclophosphamide, vincristine and doxorubicin. Stem cell transplantation is used to replace damaged bone marrow cells due to chemotherapy.

Multiple Myeloma

Recently, a team of researchers led by Andrzej J. Jakubowiak, MD, Ph.D., professor of medicine and director of the Multiple Myeloma Program at the University of Chicago Medical Center, found that multiple myeloma patients respond better to  carfilzomib – lenalidomide and low-dose dexamethasone combination. Carfilzomib is second generation proteasome inhibitor (it binds irreversibly to chymotrypsin-like activity of the 20S proteasome).

The study results were presented at the American Society of Clinical Oncology’s Annual Meeting in Chicago, IL, USA, included 53 patients recently diagnosed with multiple myeloma. Patients followed the treatment with all three drugs during the study and doses of carfilzomib were doubled. Of the 53  initially enrolled , only 36 patients remained. After at least eight 28-day cycles of treatment, 61% had a complete response. Regarding stagnation of disease, more than 90% of patients had no progression of disease. Dr. Jakubowiak, who led the team of researchers, noted that the patients response was faster and more durable than previous therapies. He added that patient tolerance was better because there were fewer cases of peripheral neuropathy.