According to results recently presented at the 2005 annual meeting of the American Society of Hematology (ASH), treatment with the agent Velcade® (bortezomib) produces high anti-cancer response rates in patients with newly-diagnosed 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 and produce antibodies to help fight infection and disease. Multiple myeloma is characterized by an excess production of abnormal plasma cells, which can result in symptoms such as increased risk for bacterial infections or impaired immune responses. Other effects of myeloma may include damage to the kidneys, osteoporosis, anemia and an elevated blood calcium level.
Treatment options for multiple myeloma depend upon how advanced the disease is, prior treatment, the patient’s overall general health and/or the patient’s age. Treatment options may include watchful waiting, chemotherapy, radiation, biologic therapy and, in some cases, stem cell transplantation.
Velcade is a newer type of therapy known as proteasome inhibitor. It works by disrupting cellular processes and causing death of cancer cells. It is currently approved for the treatment of multiple myeloma in patients who have received prior therapy.
Researchers from the Salick Health Care Research Network recently conducted a clinical trial to evaluate Velcade as treatment for multiple myeloma in patients who had not received prior therapy. The trial included 50 patients who were to undergo a subsequent stem cell transplant. Patients were treated with Velcade plus the steroid dexamethasone (Decadron®) if they had not achieved anti-cancer responses with Velcade after 2 cycles.
• Overall anti-cancer response rates were achieved in 90% of patients.
• Complete response (complete disappearance of detectable cancer) or near complete response was achieved in 18% of patients; partial response (partial disappearance of cancer) was achieved in 71% of patients.
• Major side effects were loss of sensation in hands and feet, fatigue and constipation.
• Nearly half of the patients underwent a successful subsequent stem cell transplant.
The researchers concluded that Velcade appears promising as initial treatment for patients with multiple myeloma, achieving high anti-cancer responses and allowing for successful subsequent stem cell transplants. Further studies are warranted to evaluate Velcade in the treatment of multiple myeloma.
Patients with newly-diagnosed multiple myeloma may wish to speak with their physician regarding their individual risks and benefits of participation in a clinical trial further evaluating Velcade or other promising novel treatment agents.
Reference: Jagannath S, Durie B, Wold J, et al. Bortezomib therapy alone and in combination with dexamethasone for patients with previously untreated multiple myeloma. Blood. 2005;106:231a. Abstract # 783.
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