Thalomid/Alkeran/Prednisone 2007 Standard of Care as Treatment of Myeloma

Cancer Connect

According to an article recently published in The Lancet, the treatment combination consisting of Thalomid® (thalidomide), Alkeran® (melphalan), and prednisone should be considered the new standard of care for elderly patients with multiple myeloma who have not received previous therapy.

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.

Standard therapy for multiple myeloma depends upon several factors, including the stage (extent of spread) of disease, patient age, and/or the existence of other medical conditions. Chemotherapy in combination with steroids remains the cornerstone of therapy for multiple myeloma. Thalomid is an agent that prevents or reduces the growth of blood vessels that supply food and nutrients to the cancer cells, thereby decreasing the growth and spread of cancer. Thalomid has demonstrated effectiveness in the treatment of multiple myeloma.

Researchers from France recently conducted a clinical study further evaluating the addition of Thalomid to chemotherapy in the treatment of multiple myeloma. This study included 447 patients with multiple myeloma who had not received prior therapy between 2000 and 2005. Patients were assigned to one of the following three treatment options: 1) Thalomid/Alkeran/prenisone; 2) Alerkeran/prednisone; 3) reduced-intensity stem cell transplant (chemotherapy followed by stem cell infusion to restore levels of blood cells following therapy).

  • Median overall survival times were as follows: 51.6 months for patients treated with Thalomid/Alkeran/prednisone; 33.2 months for patients with Alkeran/prednisone; 38.3 months for patients treated with a reduced-intensity stem cell transplant.
  • The addition of Thalomid to therapy significantly improved survival compared with the other treatment regimens.

The researchers concluded: “The results of our trial provide strong evidence to indicate that the use of thalidomide in combination with melphalan and prednisone should, at present, be the reference treatment for previously untreated elderly patients with multiple myeloma.” Elderly patients with multiple myeloma may wish to speak with their physician regarding their individual risks and benefits of all treatment options.

Reference: Facon T, Mary J, Hulin C, et al. Melphalan and prednisone plus thalidomide versus melphalan and prednisone alone or reduced-intensity autologous stem cell transplantation in elderly patients with multiple myeloma (IFM 99-06): a randomised trial. The Lancet. 2007;370:1209-1218.


Multiple Myeloma