The results from a new study indicate that treatment of newly diagnosed multiple myeloma with novel therapeutic agents improves kidney function in most patients, in comparison to treatment with conventional chemotherapy and a high-dose regimen of dexamethasone ^[1] (Decadron). The authors of the study presented the results of the clinical trial on December 8 at the 51^st American Society of Hematology (ASH) Annual Meeting and Exposition.

Multiple myeloma patients commonly experience complications with kidney function, and kidney impairment is associated with increased mortality rates. The Myeloma Beacon recently published a series ^[2] of articles on kidney impairment that discuss treatment options; time and care commitments; and hemodialysis, a medical procedure in which a machine serves as an “artificial kidney”.

Patients experiencing kidney impairment are frequently treated with high-dose dexamethasone-based regimens. The purpose of the present study was to examine the efficacy of novel therapeutic agent-based regimens on improving kidney impairment in newly diagnosed myeloma patients.

In the study, researchers randomly assigned 82 newly diagnosed myeloma patients with impaired kidney function to one of three treatment groups. Patients in group A received conventional chemotherapy, in addition to a dexamethasone-based regimen. Group B and group C were given novel therapeutic agents. Patients in group B received treatment with thalidomide ^[3] (Thalomid) or Revlimid ^[4] (lenalidomide) with high-dose dexamethasone and/or cyclophosphamide ^[5] or melphalan. Group C patients received treatment with Velcade ^[6] (bortezomib) and dexamethasone.

Patients treated with novel therapeutic agents experienced the greatest improvement in kidney function (87 percent in group B and 94 percent in group C). By comparison, 64 percent of patients treated with conventional chemotherapy experienced improvement in kidney function. In addition, 43 percent of group A patients achieved a complete response, compared to 50 percent of group B patients and 69 percent of group C patients.

Researchers also examined the median time it took patients to achieve a minor response to the treatments. The median times for group A and group B were similar (two months vs. 1.5 months, respectively), whereas the median time for group C was significantly shorter (0.7 months).

Based on the results of this study, the researchers concluded that novel therapeutic agents improve kidney function in the majority of myeloma patients. Furthermore, Velcade-based treatment improves kidney function more effectively and more rapidly than treatment with conventional chemotherapy and dexamethasone and treatment with thalidomide or Revlimid. This pattern held true even for patients with severe kidney failure, which led researchers to conclude that Velcade-based regimens may be the preferred method of treatment for newly diagnosed myeloma patients with kidney failure.

For more information, see abstract 955 ^[7] at the ASH meeting Web site.