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According to a recent article published in the Journal of Clinical Oncology, the treatment combination consisting of Velcade® (bortezomib) and melphalan (Alkeran®) provides encouraging anticancer activity in the treatment of multiple myeloma that has stopped responding to standard therapies.

Multiple myeloma is a cancer involving important immune (infection-fighting) cells called plasma cells. It is the second most common hematologic (blood) cancer in the U.S., where an estimated 50,000 individuals are currently living with multiple myeloma.

Plasma cells help the body fight infection by producing specialized proteins called antibodies that target and kill foreign cells. In multiple myeloma, cancerous plasma cells produce abnormal and excessive antibodies that do not have the ability to properly fight infection. In addition, the cancerous plasma cells accumulate in the bone marrow, which suppresses the formation and function of other cells necessary for normal production of blood cells and immune functions. This excessive accumulation of cancer cells in the bone marrow ultimately leads to the formation of tumors in the bone and to the breakdown of bone.

If multiple myeloma returns following therapy, it is referred to as recurrent. Effective and easily tolerated treatment options are limited for patients with recurrent multiple myeloma.

Velcade is an agent approved for patients with multiple myeloma whose disease has progressed following one or more previous therapies. Velcade offers a new avenue for treatment: As a proteosome inhibitor, it interferes with the growth and survival of cancer cells responsible for recurrent multiple myeloma.

Proteosomes are proteins found in virtually all cells that are responsible for the breakdown and reuse of a cell’s other proteins. Proteosomes regulate several aspects of cellular activity, including survival.

Velcade has demonstrated an inhibitory effect on cellular survival through its effects on proteosomes. The drug also makes cancer cells more vulnerable to the killing effects of chemotherapy in refractory myeloma cells.

Evaluation of Velcade continues in the treatment of different stages of multiple myeloma, as well as in the treatment of other types of cancer. Pre-clinical studies have indicated that the combination of Velcade and the chemotherapy agent melphalan, which is commonly used in the treatment of multiple myeloma, may provide greater anticancer activity than either agent alone.

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Researchers recently conducted a clinical trial to evaluate the combination of Velcade and melphalan in patients with multiple myeloma that had stopped responding to standard therapies. This trial included 34 patients.

The combination of Velcade and melphalan provided significant anticancer activity in patients who had received prior therapy:

  • Anticancer responses occurred in 68% of patients.
  • Among six patients who received the highest doses of Velcade/melphalan, anticancer responses occurred in 83%.
  • Median progression-free survival was 8 months.
  • Serious side effects were mostly related to low levels of blood cells.

The researchers concluded that the treatment combination consisting of Velcade and melphalan appears to be a promising therapy for treatment of patients with multiple myeloma that has returned or stopped responding to standard therapies.

Patients with multiple myeloma who have received prior therapies may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating Velcade/melphalan or other promising therapeutic approaches.

Reference: Berenson J, Yang H, Sadler K, et al. Phase I/II Trial Assessing Bortezomib and Melphalan Combination Therapy for the Treatment of Patients With Relapsed or Refractory Multiple Myeloma. Journal of Clinical Oncology. 2006; 6: 937-944.

Related News:Updated Results: Velcade® Improves Survival Over Dexamethasone in Recurrent Multiple Myeloma (1/30/06)

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