Life is changing quickly even for high risk patients with 17P. WooHOOO. Great news with proteasome inhibitors!
K Neben et al, "Administration of bortezomib before and after autologous stem-cell transplantation improves outcome in multiple myeloma patients with deletion 17p," Blood, December 8, 2011 (full text pdf; or abstract)
Abstract:
In patients with Multiple Myeloma (multiple myeloma), risk stratification by chromosomal abnormalities may enable a more rational selection of therapeutic approaches. Here we analyzed the prognostic value of 12 chromosomal abnormalities in a series of 354 multiple myeloma patients treated within the HOVON-65/GMMG-HD4 trial. Because of the two-arm design of the study, we were able to analyze the effect of a bortezomib-based treatment before and after autologous stem-cell transplantation (arm B) in comparison to standard treatment without bortezomib (arm A). For all analyzed chromosomal aberrations, progression free survival (PFS) and overall survival (OS) were at least equal or superior in the bortezomib-arm as compared to the standard arm. Strikingly, patients with del(17p13) benefitted most from the bortezomib-containing treatment (median PFS time: A: 12.0 months, B: 26.2 months, p=0.024; 3yr-OS rates: A: 17%, B: 69%, p=0.028). After multivariate analysis, del(17p13) was an independent predictor for PFS (p<0.0001) and OS (p<0.0001) in arm A, whereas no statistical significant effect on PFS (p=0.28) and OS (p=0.12) was seen in arm B. In conclusion, the adverse impact of del(17p13) on PFS and OS could be significantly reduced by the bortezomib-based treatment, suggesting that long-term administration of bortezomib should be recommended for patients carrying del(17p13). This trial is registered at ISRCTN as ISRCTN64455289
Related Beacon news article:
"Velcade-Based Therapy May Improve Survival Of Multiple Myeloma Patients With Deletion In chromosome 17," The Myeloma Beacon, February 24, 2012
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Re: Velcade for high risk 17P - good news
Hi SuzieRose,
I did induction chemo with bortezomib plus dex. Revlimid was not yet approved for use in Canada, so there were not very many options available, outside of clinical trials. I really didn't know that much about myeloma, and did not know whether or not I was 'high risk' at the time. My oncologist did not refer to 'staging' (I think it would have been stage 3, due to my 50% plasma cells in the marrow, and fractured vertebrae). I think possibly he did not want to panic me too much.
Within a matter of four cycles (about four months), my monoclonal proteins were down by 95%, and my BMB test was clear! I wouldn't be at all surprised if patients with a chromosomal deletion responded well also. Later, before the SCT, I was tested for chromosomal deletions. Don't think I have that problem at least, although that was one set of lab tests I forgot to request a copy of!
I did induction chemo with bortezomib plus dex. Revlimid was not yet approved for use in Canada, so there were not very many options available, outside of clinical trials. I really didn't know that much about myeloma, and did not know whether or not I was 'high risk' at the time. My oncologist did not refer to 'staging' (I think it would have been stage 3, due to my 50% plasma cells in the marrow, and fractured vertebrae). I think possibly he did not want to panic me too much.
Within a matter of four cycles (about four months), my monoclonal proteins were down by 95%, and my BMB test was clear! I wouldn't be at all surprised if patients with a chromosomal deletion responded well also. Later, before the SCT, I was tested for chromosomal deletions. Don't think I have that problem at least, although that was one set of lab tests I forgot to request a copy of!
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Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
Re: Velcade for high risk 17P - good news
This is wonderful news, Suzierose, especially considering that bortezomib (Velcade) is now being used as an injection with less risk of neuropathies! Thanks for sharing, as always!
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Lisa B. - Name: Lisa B.
- Who do you know with myeloma?: My mother, Barbara Henson
- When were you/they diagnosed?: 10-28-11
- Age at diagnosis: 71
Re: Velcade for high risk 17P - good news
This is the best news I have heard about del17. Finally some data showing that there is a treatment option that is impacting this group.
Thank you Suzierose!
I will be discussing this with the doctor. My dad's doctor is advising against an SCT because there is data that shows that in high risk patients, there may not be a huge gain and similar results may be achieved utilizing novel therapies.
He also recognizes that the process can be very hard on patients and QOL issues should be considered.
Now I have more questions after reading this study. Perhaps an SCT needs to be explored more. Would love to see a study that shows how Velcade alone impacts del17 patients.
Thanks again for all the great info.
Thank you Suzierose!
I will be discussing this with the doctor. My dad's doctor is advising against an SCT because there is data that shows that in high risk patients, there may not be a huge gain and similar results may be achieved utilizing novel therapies.
He also recognizes that the process can be very hard on patients and QOL issues should be considered.
Now I have more questions after reading this study. Perhaps an SCT needs to be explored more. Would love to see a study that shows how Velcade alone impacts del17 patients.
Thanks again for all the great info.
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