[TerryH]

Treanda (bendamustine) and melphalan

by TerryH on Wed Sep 24, 2014 7:15 pm

There have been discussions here lately in the forum about Treanda (bendamustine). This reminded me of a study I saw about Treanda that I think people should know about. Here's the reference:

S Surget et al, "Bendamustine and melphalan kill myeloma cells similarly through reactive oxygen species production and activation of the p53 pathway and do not overcome resistance to each other," Leukemia & Lymphoma, September 2014, Vol. 55, No. 9 , Pages 2165-2173

What the study basically says is that, when the authors did laboratory tests of both Treanda and melphalan separately and together, to see what sort of anti-myeloma activity they have, they found that the two drugs behave basically the same.

So, if a myeloma patient has been treated with melphalan, then treating the patient with Treanda sometime later is not likely to have much more success than you would get treating the patient again with melphalan. And vice versa.

This is important for a couple of reasons.

First, melphalan is cheap, but Treanda, because it is still patent protected, is not.

Second, you don't see researchers publishing studies like this very often, since so much money for research comes from companies that have patent-protected drugs. So, when I see a study like this, I give it a little more weight than I might otherwise.

Many of you probably know this, but there is a reason that the results of this study shouldn't be all that surprising. Both Treanda and melphalan come from the same category of drugs known as alkylating agents. In fact, they come from the same subcategory of these drugs, known as "nitrogen mustards." Cytoxan is in that same subcategory.

Now, to be fair, I'll add that there also has been a study published that argues that there is a difference in the way Treanda and melphalan act against myeloma.

M Cives et al, "Bendamustine overcomes resistance to melphalan in myeloma cell lines by inducing cell death through mitotic catastrophe," Cellular Signalling, Volume 25, Issue 5, May 2013, Pages 1108–1117.

If that's true, then treating a patient with Treanda who has previously had melphalan may be more effective than just re-treating the patient with melphalan.

I personally think the first study is more convincing, but we can get into that some more if people what to discuss it more.

Also, although I can't check this, I would not be the least surprised if this second study was written by authors who received at least some financial support from the company that sells Treanda.

[Nancy Shamanna]

Re: Treanda (bendamustine) and melphalan

by Nancy Shamanna on Thu Sep 25, 2014 9:30 am

Thanks Terry for the info on Treanda (bendamustine). It is not approved for use with myeloma patients in Canada, but I have heard of it from time to time as a possible treatment. It's good to know more about it actually.