According to an article recently published in the Annals of Oncology, the addition of Thalomid® (thalidomide) to VAD-Doxil (vincristine, liposomal doxorubicin, and dexamethasone) improves progression-free survival compared to VAD-Doxil when used as initial therapy for patients with multiple myeloma.
Multiple myeloma is a cancer of the blood that affects the plasma cells. Plasma cells are an important part of the immune system; they produce antibodies to help fight infection and disease. Multiple myeloma is characterized by an excess production of abnormal plasma cells. Symptoms include increased risk of bacterial infections and impaired immune responses. Because patients whose cancer has returned following prior therapy are typically considered incurable, treatment is aimed at extending survival as well as maintaining quality of life.
VAD-Doxil is a commonly used chemotherapy and steroid regimen for multiple myeloma, and Thalomid is an FDA-approved drug for the treatment of patients with multiple myeloma. Although these treatments are available, there are still many unanswered questions about the optimal use of Thalomid or combination therapy for the treatment of multiple myeloma. In an effort to determine optimal treatment for this disease, recent studies have focused on various combinations with Thalomid for initial therapy.
Researchers from Greece recently conducted a clinical trial to evaluate the addition of Thalomid to VAD-Doxil as initial therapy for multiple myeloma. This trial included 232 newly diagnosed patients who were treated with either Thalomid/VAD-Doxil or VAD-Doxil. The following table summarizes the main findings of this trial:
Trial Results for Patients Treated with Thalomid/VAD-Doxil or VAD-Doxil
The rate of overall side effects was greater in the group treated with Thalomid; however, the rate of severe side effects was similar between the two groups. Side effects uniquely associated with Thalomid included constipation, peripheral neuropathy (loss of sensation of the palms of hands or soles of feet), skin rash, and edema (swelling).
The researchers concluded that the addition of Thalomid to VAD-Doxil improves progression-free survival and might improve overall survival compared to VAD-Doxil when used as initial therapy in multiple myeloma. However, it is not clear that use of Thalomid in initial therapy regimens would improve survival over its use once patients have disease progression. Patients with multiple myeloma may wish to discuss their individual risks and benefits of available treatment options with their physician.
Reference: Zervas K, Mihou D, Katodritou E, et al. VAD-doxil versus VAD-doxil plus thalidomide as initial treatment for multiple myeloma: results of the Greek Myeloma Study Group. Annals of Oncology. 2007; 18:1369-1375.