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According to an article recently published in Annals of Oncology, the treatment combination consisting of Revlimid® (lenalidomide), Oncovin® (vincristine), Doxil® (pegylated doxorubicin), and dexamethasone appears highly effective in multiple myeloma that has recurred or progressed following prior therapies.

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.

Treatment options for multiple myeloma were historically restricted to chemotherapy; however, treatment is rapidly evolving as newer agents such as Velcade® (bortezomib), Thalomid® (thalidomide), and Revlimid are becoming more commonly used. These newer agents tend to be well tolerated, which is an important consideration for elderly patients, who tend not to tolerate aggressive therapies as well as younger patients. Researchers continue to evaluate novel strategies in order to offer all patients optimal and individualized treatment options.

Determining optimal treatment choices for patients with multiple myeloma that has recurred (returned following therapy) or for those with refractory disease (stopped responding to therapy) is more challenging than for those who have not received prior therapies.

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Researchers from the Cleveland Clinic recently conducted a clinical trial to evaluate the combination of Doxil, Oncovin, Revlimid, and dexamethasone in the treatment of patients with recurrent or refractory multiple myeloma. Both Doxil and Oncovin are chemotherapy agents commonly used for multiple myeloma. This trial included 62 patients, 65% of whom had recurrent or refractory multiple myeloma.

  • Seventy-five percent of patients achieved an anticancer response.
  • Twenty-nine percent of patients achieved a complete or near complete disappearance of detectable cancer.
  • Progression-free survival was one year.
  • Overall survival has not yet been reached.
  • The main side effect from the addition of Revlimid to this treatment combination was infection.

The researchers concluded that the treatment combination including Revlimid, Doxil, Oncovin, and dexamethasone appears to provide high anticancer activity in recurrent or refractory multiple myeloma. Patients whose multiple myeloma has returned or progressed following prior therapies may wish to speak with their physician regarding participation in clinical trials further evaluating novel treatment combinations.

Reference: Baz R, Walker E, Karam MA, et al. Linalidomide and pegylated liposomal doxorubicin-based chemotherapy for relapsed or refractory multiple myeloma: safety and efficacy. Annals of Oncology. 2006; published online on September 15, 2006 as doi:10.1093/annonc/mdl313.