Preliminary results from a clinical trial designed to assess the effect of adding thalidomide (Thalomid) to induction therapy prior to autologous stem cell transplantation show that it increases response rates in both young and elderly multiple myeloma patients. These results were presented on December 7^th at the 51^st American Society of Hematology (ASH) meeting.

A total of 1,970 multiple myeloma patients participated in this trial, which split patients up into two separate groups based on age. The younger patients, median age 59 years, were randomized to receive one of two induction therapies – either cyclophosphamide (Cytoxan), thalidomide, and dexamethasone (Decadron); or vincristine (Oncovin), doxorubicin (Adriamycin), and dexamethasone. The older patients, median age 73 years, were randomized to receive either melphalan (Alkeran) and prednisone or cyclophasphamide, thalidomide, and dexamethasone.

All patients were given these chemotherapy combination regimens, called induction therapies, to decrease the number of myeloma cells prior to receiving an autologous stem cell transplant.  

Both groups had the option of taking low-dose thalidomide as maintenance therapy following the transplant.

The addition of thalidomide to induction therapy resulted in higher response rates in young patients –91% of patients who received induction therapy that included thalidomide responded, compared with 82% of patients who did not receive thalidomide.  The drug also affected the complete response rates: 21% of the patients who received thalidomide achieved a complete response, compared with 14% for those who did not.

In older patients, induction therapy with thalidomide significantly increased response rates. The response rate was 83% for those who received cyclophosphamide, thalidomide, and dexamethasone, compared with 46% for patients who were given melphalan and prednisone.

At the time of publication of trial results, the patients had been followed for about three years. The impact of thalidomide on overall survival is still being analyzed, but current data does not suggest that the addition of thalidomide to induction therapy has a substantial effect on survival time.

For more information, please see abstract 352 at the ASH meeting Web site.