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New Velcade Combination Therapy Effective For Newly Diagnosed Myeloma Patients (ASH 2009)

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Published: Nov 27, 2009 8:43 am

A new study suggests that Velcade (bortezomib), in combination with other drugs, is a better treatment method for patients with newly diagnosed multiple myeloma than the previous standard drugs.

The study, titled “Velcade, Intravenous Cyclophosphamide, and Dexamethasone (VCD) Induction for Previously Untreated Multiple Myeloma (German DSMM XIa Trial),” will be presented on December 6 at the American Society of Hematology (ASH) Meeting in New Orleans.

The researchers compared a drug cocktail consisting of Velcade, cyclophosphamide (Cytoxan), and dexamethasone (Decadron) with the previous standard cocktail of vincristine, doxorubicin (Adriamycin), and dexamethasone. The results suggested that the VCD combination led to cancer-free survival and better control of cancer cell proliferation.

The study enrolled 400 patients under the age of 60, who were recently diagnosed with multiple myeloma. The VCD drug combination was their first course of treatment. The patients received three 3-week cycles of the drugs, with the optimal dose of cyclophosphamide determined to be 900 mg/m2 on day 1. The patients then received high dose melphalan (Alkeran) and an autologous stem cell transplant.

During an autologous stem cell transplant, stem cells are collected from a patient’s bone marrow and later used to replace healthy cells destroyed during chemotherapy. The procedure is considered to be especially successful in younger patients.

Among the 300 evaluable patients, 84 percent achieved a response following VCD treatment and transplantation. Response rates were not significantly different for patients with unfavorable cytogenetic abnormalities.

The death rate during the study was low, with only 1.3 percent of patients dying during treatment. However, 26 percent of patients experienced unspecified serious adverse effects during therapy. More than half of the study’s participants suffered from minor adverse effects, such as low white blood cells, low platelets, or low red blood cells. Additionally, 34 percent of patients developed peripheral neuropathy.

Updated results will be presented at the ASH meeting. However, based on the intermediate results reported here, the researchers concluded that this Velcade-cyclophosphamide-dexamethasone combination is safe and effective in newly diagnosed multiple myeloma patients. The researchers suggest that this regimen may become a new standard treatment for recently diagnosed patients eligible for stem cell transplantation.

For more information, please see abstract 131 at the ASH meeting Web site.

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