The results of a recent Phase 2 trial indicate that Velcade-doxorubicin-dexamethasone treatment can reverse multiple myeloma-associated kidney damage in myeloma patients suffering from kidney failure. The regimen also improved patients’ disease statuses and was associated with few severe side effects.

Multiple myeloma affects plasma cells, a subset of white blood cells that fight infections by producing antibody. In multiple myeloma patients, cancerous plasma cells produce one kind of abnormal antibody.

In some myeloma patients, this abnormal antibody binds to a protein produced in the kidney.  These antibody-protein complexes then accumulate in the structures of the kidney, causing damage and decreased kidney function.

Kidney damage is a common and potentially serious complication in multiple myeloma. Reversal of this damage can only be achieved by preventing the accumulation of protein-antibody complexes in the kidney.

Previous studies have suggested that Velcade ^[1] (bortezomib) and Velcade-based regimens are particularly effective in reversing kidney damage in multiple myeloma patients.

Additionally, the active compounds in Velcade are broken down in the body through processes that do not involve the kidneys. As a result, Velcade does not interfere with kidney function and usually does not cause kidney-related side effects.

In this clinical trial, researchers investigated the efficacy of Velcade-doxorubicin ^[2] (Adriamycin)-dexamethasone ^[3] (Decadron) (referred to as VDD) in myeloma patients with antibody-associated kidney damage and the treatment’s potential of restoring kidney function in this patient population.

Sixty-eight multiple myeloma patients with antibody-associated kidney damage were treated with VDD. During the study, patients received a median of eight treatment cycles.

A total of 66 percent of patients achieved a partial response or better, and 38 percent of patients achieved a complete response.

Sixty-two percent of patients showed improved kidney function with VDD treatment. Kidney function was restored in 31 percent of patients.

Nine patients enrolled in the study were receiving dialysis due to severe impairment of kidney function. Three of these nine patients became dialysis-independent following treatment.

Researchers noted that kidney improvement correlated with response to treatment. Patients who achieved a complete or very good partial response showed the greatest improvement in kidney function.

Median progression-free survival time was 12 months, and the median overall survival time had not yet been reached.

Low red blood cell count was the most common and severe side effect of the treatment and was experienced by 50 percent of patients in the study.

Infection was the most severe side effect not related to blood cell levels. Serious infections were experienced by 19 percent of patients and resulted in four patient deaths.

For more information, see the article in the Journal of Clinical Oncology ^[4] (abstract).