According to an article recently published in the Journal of Cancer Research and Clinical Oncology, the chemotherapy agent Treanda™ (bendamustine) plus the steroid prednisone appears to provide superior outcomes to a standard treatment regimen consisting of the chemotherapy agent melphalan (Alkeran®) plus prednisone when used as initial therapy for multiple myeloma. Treanda is still in clinical trials and not yet approved in the U.S.
Multiple myeloma is a cancer of the blood that affects the plasma cells. Plasma cells, which produce antibodies to help fight infection and disease, are a vital part of the immune system. In multiple myeloma an excess of abnormal plasma cells is produced. This creates symptoms such as increased risk for bacterial infections and impaired immune responses. Other effects of myeloma may include damage to the kidneys, osteoporosis, anemia, and an elevated blood calcium level.
Often, patients with multiple myeloma are elderly and unable to tolerate aggressive therapy. This has led to the development of novel agents that produce anticancer activity in patients with multiple myeloma, but are easily administered and tolerated.
Treanda is a chemotherapy agent that is currently in phase II testing for several diseases. One advantage of Treanda is that it does not interfere with other commonly used chemotherapy agents referred to as alkylating agents. Treanda has been marketed and used clinically in Germany for many years in patients with NHL, chronic lymphocytic leukemia (CLL), multiple myeloma, breast cancer, and other solid tumors such as lung cancer.
Researchers from Germany recently conducted a clinical trial further evaluating Treanda in the treatment of multiple myeloma. This trial included 131 patients with newly diagnosed multiple myeloma who were treated with either Treanda plus prednisone or melphalan plus prednisone as initial therapy for their disease.
The combination of Treanda/prednisone appeared superior to melphalan/prednisone for this group of patients:
- The overall anticancer response rates were 75% for patients treated with Treanda/prednisone and 70% for those treated with melphalan/prednisone.
- The complete response rate (complete disappearance of detectable cancer) was 32% for patients treated with Treanda/prednisone, compared to only 13% for those treated with melphalan/prednisone.
- Maximum anticancer responses were achieved after approximately seven cycles of therapy in patients treated with Treanda/prednisone, compared with nearly nine cycles of therapy in patients treated with melphalan/prednisone.
- The average duration of time before treatment stopped working (treatment failure) was significantly longer for patients treated with Treanda/prednisone than for those treated with melphalan/prednisone.
- Quality of life, including pain, was significantly improved for patients treated with Treanda/prednisone compared to those treated with melphalan/prednisone.
The researchers concluded that treatment with Treanda/prednisone appears to provide superior outcomes (including quality of life) to melphalan/prednisone for patients with newly diagnosed multiple myeloma. However, further trials are necessary to confirm these findings. One disadvantage of Treanda over melphalan is that it requires intravenous administration, whereas melphalan is administered orally.
The researchers did recommend that based on these findings, Treanda/prednisone should be considered for initial therapy in patients with multiple myeloma who are not eligible for a transplant. Patients diagnosed with multiple myeloma may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating Treanda or other promising therapeutic options.
Reference: Ponish W, Mitrou PS, Merkle K, et al. Treatment of bendamustine and prednisone in patients with newly diagnosed multiple myeloma results in superior complete response rate, prolonged time to treatment failure and improved quality of life compared to treatment with melphalan and prednisone-a randomized phase III study of the East German Study Group of Hematology and Oncology (OSHO). Journal of Cancer Research and Clinical Oncology. 2006 Jan 10;:1-8[Epub ahead of print].