Researchers from Canada have found that long exposure to novel agents as well as achievement of higher response rates contribute to long-term survival in multiple myeloma patients.  They presented their findings at the American Society of Hematology Meeting (ASH) on December 6.

The term “long-term survivor” refers to a person who is alive for ten or more years following diagnosis of myeloma. Long-term survival is still unusual in multiple myeloma. Less than 10 percent of patients fall into the category of long-term survivors.

Velcade (bortezomib), thalidomide (Thalomid) and Revlimid (lenalidomide) are frequently referred to as novel agents in multiple myeloma.

The researchers examined 39 long-term multiple myeloma survivors who were diagnosed at Princess Margaret Hospital in Toronto between January of 1994 and November of 1998. The purpose of this study was to look specifically at these patients to determine if there were factors that contributed to their treatment success and extended lifespan.

Information regarding their treatments, responses to treatments, age, and other factors were collected for these 39 patients. This information was compared with a control group of 47 multiple myeloma patients who survived for less than 10 years after diagnosis.

The median age of diagnosis for the long-term survivor group was 51 years, and 56 percent of these patients were male. Among these patients, 97 percent had previously received an autologous stem cell transplant at a median age of 53 years.

In comparison with the control group, fewer long-term survivors had received thalidomide. However, those long-term survivors who received thalidomide were treated with it for a much longer period of time than patients in the control group (28 months compared with 8.5 months).

In the long-term survivor group, time from diagnosis to treatment with Revlimid, thalidomide, or Velcade was, on average, much longer than for the control group. For long-term survivors, the average time from diagnosis to exposure to these three therapies wass 88 months, compared with 67 months for the control group. Similar to the results seen with thalidomide, long-term survivors that were treated with Velcade stayed with that regimen significantly longer than the control group, (five months compared with two months). As expected, long-term survivors also reported higher response rates to the novel agents.

The most significant result from this study is that patients who survived for 10 years or longer were more likely to be treated with thalidomide, Velcade, or Revlimid for a longer duration of time compared with the control group. Long-term survivors were also more likely to have responded well to treatments. The authors did not find any evidence that a shorter time interval between diagnosis and treatment contributed to long term survival.

For more information, please read abstract 2793 at the ASH meeting Web site.