According to results recently published in the journal Blood, Vecade® (bortezomib) is a safe treatment option for patients with multiple myeloma who have kidney failure.
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.
A significant portion of patients diagnosed with multiple myeloma have complications with their kidneys. At times, this may require dialysis, a procedure where waste is filtered from the blood by a special machine when the kidneys are not functioning. Several agents that are used for treatment of multiple myeloma produce side effects that alter kidney function. Therefore, patients multiple myeloma who experience renal (kidney) failure have limited treatment options.
Velcade is considered a proteosome inhibitor. Proteosomes are proteins found in virtually all cells. They are responsible for the breakdown and reuse of a cell’s other proteins. Proteosomes regulate several aspects of cellular activity, including survival. By inhibiting proteosomes, Velcade has demonstrated an ability to inhibit cellular survival.
Researchers from Roswell Park Cancer Center, Emory University, Northwestern University, and the Dana-Farber Cancer Center recently evaluated the safety and effectiveness of Velcade among patients with multiple myeloma with renal failure. This study included 24 patients, 23 of whom were receiving kidney dialysis. Two patients were treated with Velcade alone, while the others were treated with Velcade combined with dexamethasone, dexamethasone and Thalomid®, Doxil® plus Thalomid®, or other treatment combinations.
- 75% of patients achieved an anticancer response.
- 25% of patients achieved a complete disappearance of cancer (complete response).
- 15% of patients achieved disease stabilization or a minimal response.
- The median duration of responses was approximately one year.
- The median duration of complete responses was 15 months.
- Four patients had improved kidney function that allowed them to discontinue dialysis.
- Eight patients discontinued treatment (six patients due to progressive disease and two patients due to side effects of treatment).
The researchers concluded that patients with multiple myeloma and renal failure are able to tolerate treatment with Velcade. The authors stated that these results are comparable to results for patients treated with Velcade who do not have renal failure.
Patients diagnosed with multiple myeloma who have renal failure may wish to discuss their individual risks and benefits of treatment with Velcade with their physician.
Reference: Chanan-Khan A, Kaufman J, Mehta J, et al. Activity and safety of bortezomib in multiple myeloma patients with advanced renal failure: a multicenter prospective study. Blood. 2007;109:2604-2606.