Hi Julie,
Thanks for your coverage. I'm wondering if you can update us on any non-conventional treatment discussions happening? For example, any focus on curcumin or other natural treatments?
Thanks,
Jessica
PS Also, can you list the survival rates you mentioned above for those under 65 who receive a transplant early vs late? You mention a difference, but I'm wondering what the rates were?
Forums
Re: ASH 2010 Multiple Myeloma Discussion - Day 2
Hi redheadj,
Excellent questions.
For patients under the age of 65 who survived the first 4 cycles of therapy, 1 year overall survival rates were 100% for those who received an early transplant and 94% for those who continued with Revlimid/dexamethasone treatment, and 3 year overall survival rates were 94% with early transplantion and 78% without early transplantation.
If you're interested in any other breakdowns, such as other age groups or by dexamethasone dosage, they are provided in the abstract for the talk: http://ash.confex.com/ash/2010/webprogram/Paper34824.html
One thing to keep in mind is that in the over 70 group, the numbers for those who received a transplant are very small, so Dr. Siegel said that none of the comparisons were statistically significant.
There has been almost no mention of natural treatments at all. It's not entirely surprising given the general lack of research on these natural products. There hasn't been any mention of curcumin at all. There was one poster presentation last night about preclinial research showing that SIRT1720, which is related to resveratrol, is toxic to myeloma cells.
Excellent questions.
For patients under the age of 65 who survived the first 4 cycles of therapy, 1 year overall survival rates were 100% for those who received an early transplant and 94% for those who continued with Revlimid/dexamethasone treatment, and 3 year overall survival rates were 94% with early transplantion and 78% without early transplantation.
If you're interested in any other breakdowns, such as other age groups or by dexamethasone dosage, they are provided in the abstract for the talk: http://ash.confex.com/ash/2010/webprogram/Paper34824.html
One thing to keep in mind is that in the over 70 group, the numbers for those who received a transplant are very small, so Dr. Siegel said that none of the comparisons were statistically significant.
There has been almost no mention of natural treatments at all. It's not entirely surprising given the general lack of research on these natural products. There hasn't been any mention of curcumin at all. There was one poster presentation last night about preclinial research showing that SIRT1720, which is related to resveratrol, is toxic to myeloma cells.
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Julie Shilane - Name: Julie Shilane, Beacon Staff
Re: ASH 2010 Multiple Myeloma Discussion - Day 2
The next study was presented by Dr. Keith Stewart. In this study, all patients received a stem cell transplant and then half received thalidomide/prednisone maintenance, and the other half received no maintenance (just observation).
Previous studies have shown that thalidomide maintenance extends PFS, but overall survival results vary. This study also looked at quality of life.
PFS was 28 months for the maintenance group vs 17 months for observation. 4 yr PFS was 32% for maintenance vs 14% for the observation group. 4 year survival was 68% for maintenance and 60% for observation. Median 5 year overall survival was not yet reached for the maintenance group; the trend was in favor of maintenance, but the difference wasn’t significant. Survival after relapse was shorter for the maintenance group.
Side effects were higher in in the maintenance group, including neuropathy (10% vs 1%). A number of patients discontinued therapy do to thalidomide side effects. At one year, 85% remained on maintenance; 70% remained on therapy at relapse.
Patients reported a worsening of quality of life when on maintenance therapy. They commonly reported constipation, numbness, thirst, and swelling in legs.
Previous studies have shown that thalidomide maintenance extends PFS, but overall survival results vary. This study also looked at quality of life.
PFS was 28 months for the maintenance group vs 17 months for observation. 4 yr PFS was 32% for maintenance vs 14% for the observation group. 4 year survival was 68% for maintenance and 60% for observation. Median 5 year overall survival was not yet reached for the maintenance group; the trend was in favor of maintenance, but the difference wasn’t significant. Survival after relapse was shorter for the maintenance group.
Side effects were higher in in the maintenance group, including neuropathy (10% vs 1%). A number of patients discontinued therapy do to thalidomide side effects. At one year, 85% remained on maintenance; 70% remained on therapy at relapse.
Patients reported a worsening of quality of life when on maintenance therapy. They commonly reported constipation, numbness, thirst, and swelling in legs.
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Julie Shilane - Name: Julie Shilane, Beacon Staff
Re: ASH 2010 Multiple Myeloma Discussion - Day 2
The next talk was given by Dr. Pieter Sonneveld. He spoke about Velcade induction prior to high-dose melphalan and stem cell transplantation followed by Velcade maintenance.
Half of the patients received VAD induction, melphalan treatment, auto or allo transplantation, (some received a second transplant), followed by maintenance with thalidomide for 2 years. The other half received the same treatment except with PAD induction (P=Velcade) and Velcade maintenance.
Responses, PFS, and overall survival were all better in the Velcade group. Additionally, more patients remained on Velcade treatment due to thalidomide toxicity issues.
Half of the patients received VAD induction, melphalan treatment, auto or allo transplantation, (some received a second transplant), followed by maintenance with thalidomide for 2 years. The other half received the same treatment except with PAD induction (P=Velcade) and Velcade maintenance.
Responses, PFS, and overall survival were all better in the Velcade group. Additionally, more patients remained on Velcade treatment due to thalidomide toxicity issues.
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Julie Shilane - Name: Julie Shilane, Beacon Staff
Re: ASH 2010 Multiple Myeloma Discussion - Day 2
The next talk was given by Dr. Amrita Krishnan comparing auto-auto transplants with auto-allo transplants. I described the results earlier in the day, so I’ll just describe the discussion here.
In the Q&A session there was a lot of discussion about whether or not allo transplants should continue to be used. The general consensus has been that allo transplants should only be given in a clinical trial setting, but after this talk, some people were asking whether allo transplants should even be given in clinical trials anymore. Dr. Krishnan pointed out that this data is for standard risk patients and that even that data requires longer follow-up. She suggested that the use of allo transplants for ultra-high risk patients is still necessary. She and others also suggested that even among standard risk patients, allo transplants don’t have to be thrown out altogether. The goal should be to improve the results by finding ways of making the allo transplant safer.
In the Q&A session there was a lot of discussion about whether or not allo transplants should continue to be used. The general consensus has been that allo transplants should only be given in a clinical trial setting, but after this talk, some people were asking whether allo transplants should even be given in clinical trials anymore. Dr. Krishnan pointed out that this data is for standard risk patients and that even that data requires longer follow-up. She suggested that the use of allo transplants for ultra-high risk patients is still necessary. She and others also suggested that even among standard risk patients, allo transplants don’t have to be thrown out altogether. The goal should be to improve the results by finding ways of making the allo transplant safer.
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Julie Shilane - Name: Julie Shilane, Beacon Staff
Re: ASH 2010 Multiple Myeloma Discussion - Day 2
The final talk of the session was given by Dr. Michele Cavo. In this study, patients received VTD or TD induction followed by melphalan and tandem transplants, then consolidation with the same regimen as the induction therapy, followed by maintenance with dexamethasone.
There were increased complete and near-complete responses with VTD (31% vs 11% CR + nCR after induction, 62% and 45% after consolidation), and the addition of Velcade improved the probability of achieving molecular remission. 3 year PFS was 68% for the VTD group and 56 percent for the TD group. Additionally, Velcade overcame the poor prognosis of patients with the chromosomal abnormality t(4;14). However, overall survival was similar for the two groups. Dr. Cavo suggested this may be due to needing a longer follow-up, a lack of enough patients in the trial, or effective salvage therapies available after relapse. Rates of severe side effects were also similar. Unlike several of the previous studies described in this session, Dr. Cavo did not report significant toxicity and discontinuation of therapy due to thalidomide use.
There were increased complete and near-complete responses with VTD (31% vs 11% CR + nCR after induction, 62% and 45% after consolidation), and the addition of Velcade improved the probability of achieving molecular remission. 3 year PFS was 68% for the VTD group and 56 percent for the TD group. Additionally, Velcade overcame the poor prognosis of patients with the chromosomal abnormality t(4;14). However, overall survival was similar for the two groups. Dr. Cavo suggested this may be due to needing a longer follow-up, a lack of enough patients in the trial, or effective salvage therapies available after relapse. Rates of severe side effects were also similar. Unlike several of the previous studies described in this session, Dr. Cavo did not report significant toxicity and discontinuation of therapy due to thalidomide use.
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Julie Shilane - Name: Julie Shilane, Beacon Staff
re: Curcumin, resveratrol, vitamin D and fish oil
My brother was diagnosed with Multiple Myeloma in April of 2009. Soon after starting treatment with Velcade he began taking Curcumin, resveratrol, vitamin D and fish oil. He is doing fine and sees his oncologist every month, who also happens to be a person that was in my class in high school.
There is a tremendous amount of studies on curcumin and its success with multiple myeloma, specifically with the MD Anderson Cancer Clinic. Simply do a Google search for all of the above supplements and start reading the scientific studies from around the world. Curcumin is also the only thing to prevent monoclonal gammopathy from proceeding to Multiple Myeloma. The combination of Curcumin and Resveratrol has also shown to increase apoptosis of cancer cells by 25% when used in combination, more than each of those items taken separately. In the past year a video presentation was given to the National Cancer Institute by MD Anderson Cancer Clinic on their clinical trials of Curcumin used on multiple myeloma patients. All you have to do is do a Google search. Curcumin is effective against a variety of different cancers as is Resveratrol, all you have to do is the research and it is all online.
I, myself, have Monclonal Gammopathy, the precursor to Multiple Myeloma, that is why I spent 4 weeks online doing the research , which not only helped my brother but helped me. Very few doctors are recommending the above because there is no money in it for the drug industry. My brother takes 4 grams of Curcumin daily along with his other supplements.
Dennis Walsh
Tallmadge, Ohio
There is a tremendous amount of studies on curcumin and its success with multiple myeloma, specifically with the MD Anderson Cancer Clinic. Simply do a Google search for all of the above supplements and start reading the scientific studies from around the world. Curcumin is also the only thing to prevent monoclonal gammopathy from proceeding to Multiple Myeloma. The combination of Curcumin and Resveratrol has also shown to increase apoptosis of cancer cells by 25% when used in combination, more than each of those items taken separately. In the past year a video presentation was given to the National Cancer Institute by MD Anderson Cancer Clinic on their clinical trials of Curcumin used on multiple myeloma patients. All you have to do is do a Google search. Curcumin is effective against a variety of different cancers as is Resveratrol, all you have to do is the research and it is all online.
I, myself, have Monclonal Gammopathy, the precursor to Multiple Myeloma, that is why I spent 4 weeks online doing the research , which not only helped my brother but helped me. Very few doctors are recommending the above because there is no money in it for the drug industry. My brother takes 4 grams of Curcumin daily along with his other supplements.
Dennis Walsh
Tallmadge, Ohio
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Dennis Walsh
Re: ASH 2010 Multiple Myeloma Discussion - Day 2
Hello Julie,do you know if the study on auto-auto v auto-allo at ASH was concerning newly diagnosed patients or patients who relapsed?Thanks,Gavin
Re: ASH 2010 Multiple Myeloma Discussion - Day 2
Hi irichardson, the auto-auto vs auto-allo study included myeloma patients 70 years or younger who had at least 3 cycles of systemic therapy (excludes localized radiation) and were within 2-10 months of the start of their initial therapy. So these were relatively newly diagnosed patients, but it may have included a few patients who relapsed quickly or were refractory to their initial treatment.
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Julie Shilane - Name: Julie Shilane, Beacon Staff
19 posts
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