CT Scans Superior Than X-Rays In Detecting Myeloma Bone Lesions – Results of a recent retrospective analysis suggest that computerized tomography (CT) scans may be superior in detecting myeloma-related bone lesions compared to conventional x-rays. A CT scan constructs a three-dimensional image of the body from a series of x-rays. In the current study, significantly more lesions were detected with CT scans than with conventional x-rays. According to the investigators, CT scans could have resulted in upstaging of the disease in 61 percent of the cases they reviewed. For more information, please see the study in the journal Cancer Investigation (abstract).

Nexavar Shows Activity In Myeloma Cells – Results of a recent preclinical study indicate that cancer drug Nexavar (sorafenib) may be active as an anti-myeloma drug. In particular, the authors of the study found that Nexavar alone and in combination with Velcade (bortezomib) induced myeloma cell death in myeloma cell lines.  In addition, when the investigators tested Nexavar in three myeloma patients, they found signs of a clinically relevant response. The authors therefore recommend that Nexavar alone, or in combination with Velcade, be investigated further in clinical trials.  The authors do not discuss, however, the apparent conflict between their findings and the results of a Phase 2 clinical trial of Nexavar in heavily pretreated myeloma patients.  The Phase 2 trial was halted several years ago after Nexavar on its own showed little or no efficacy as an anti-myeloma agent (see related Beacon news).  Nexavar is currently approved in the United States and in Europe as a treatment for kidney and liver cancer. For more information on the new study, please see the related article in the British Journal of Haematology (abstract).

Combination Of Trisenox, Vitamin C, and Velcade Safe In Previously Treated Myeloma Patients – Results of a Phase 1 study show that the combination of Trisenox (arsenic trioxide), vitamin C (ascorbic acid), and Velcade is tolerable in previously treated multiple myeloma patients. In a prior Phase 1/2 trial, treatment with a combination of Trisonex and vitamin C led to anti-myeloma activity with potentially lower toxicity than treatment with Trisenox alone. Additionally, Trisenox has been shown to enhance the activity of Velcade in preclinical studies. In the current study, researchers combined all three agents to determine whether or not the addition of Trisenox would compensate for lower, less toxic doses of Velcade. Ten myeloma patients with a median of three previous lines of therapy were treated with the three-drug combination.  The best observed response was a partial response, which was seen in only one of the ten patients. No instances were observed of severe peripheral neuropathy (pain and tingling in the extremities due to nerve damage), a common side effect of Velcade. Although the response rate seen in the study was relatively low, the authors contend that the study is too small to draw conclusions regarding Trisenox's efficacy as an anti-myeloma drug.  The researchers believe, however, that their results, combined with those of earlier studies, suggest that the Trisenox-vitamin C-Velcade combination regimen may lead to better tolerability and some clinical benefit.  Trisenox is currently approved in the United States and in Europe as a treatment for a specific form of leukemia.  Arsenic, the active component of Trisenox, has a long history of use in traditional Chinese medicine.  For more about the current study, please see the related journal article in Cancer Investigation (abstract).

Researchers Identify Gene Associated With Cancer Drug Resistance – Chinese researchers have identified a gene that may be associated with cancer drug resistance in various cancers, including multiple myeloma. In particular, the researchers found that NEK2 gene was associated with drug resistance, rapid relapse, and poor outcome in multiple cancers. They concluded that the NEK2 gene could be an important target for future cancer therapies. For more information, please see the study in the journal Cancer Cell (abstract).