On Monday of this year’s American Society of Hematology (ASH) meeting, researchers presented new results indicating that the novel treatment with Velcade (bortezomib), Doxil (doxorubicin), and dexamethasone (VDD) in newly-diagnosed myeloma patients is superior to a competing novel treatment with thalidomide (Thalomid) and dexamethasone (TD) both before and after autologous stem cell transplantation (ASCT).

From July 2003 to May 2005, 31 patients with newly-diagnosed myeloma were treated with three 5-week cycles of TD regimen at the University of Michigan Cancer Center. The trial’s results were then compared to a subsequent study conducted from July 2005 to January 2007 that treated 30 patients with newly-diagnosed myeloma with six three-week cycles of VDD regimen. Both treatment regimens were followed by ASCT. There were no differences in the eligibility criteria and patient profiles of the two studies.

The VDD regimen was an overall more successful treatment than the TD regimen. The VDD regimen had a 93 percent overall response rate, compared to an 80 percent overall response rate for TD. Forty percent of patients treated with VDD produced a complete or near complete response, compared to 10 percent of patients treated with TD. Sixty-three percent of patients treated with VDD produced a very good partial response, compared to 29 percent of patients treated with TD.

The TD regimen additionally contained more negative side effects than the VDD regimen: deep vein thrombosis (DVT) / pulmonary embolism (PE) (5 patients), constipation (2), congestive heart failure (CHF) (2), and diabetes (2). Three patients were removed from the study due to toxicities, and one died of an unexplained cause. Negative side effects experienced with the VDD regimen included fatigue (4 patients), DVT/PE (2), hand-foot syndrome (2), and pneumonia (1). No patients died from the VDD treatment.

Three months following ASCT, patients from both treatments were tested for a response rate to the treatment. The VDD-treated patients again produced higher response rates than the TD-treated patients. The VDD regimen followed by ASCT had an 87 percent overall response rate, compared to a 74 percent overall response rate for TD followed by ASCT. After transplantation, 57 percent of patients initially treated with VDD produced a complete or near complete response, compared to 29 percent of patients initially treated with TD. Seventy-seven percent of patients initially treated with VDD produced a very good partial response, compared to 48 percent of patients initially treated with TD. These results suggest that patients treated with VDD followed by ASCT may experience longer progression-free survival and possibly even overall survival.

For more information, see abstract 3713 at the ASH meeting website.