Revlimid Plus Dexamethasone Extends Progression-Free Survival In Newly Diagnosed Multiple Myeloma Patients – Results of a large international Phase 3 trial show that Revlimid ^[1] (lenalidomide) plus dexamethasone ^[2] (Decadron) ex­tends progression-free survival in newly diagnosed multiple myeloma patients who are not eligible for autologous stem cell transplantation, compared to treat­ment with melphalan ^[3] (Alkeran), prednisone ^[4], and thalidomide ^[5] (Thalomid). Based on these findings, Celgene, the manufacturer of Revlimid, will start the pro­cess of applying for approval of Revlimid as frontline treat­ment in the United States, Europe, and other countries. Although Celgene is widely used in the U.S. for the treatment of newly diagnosed myeloma patients, it is not officially approved for that use in the U.S. or any other country.  For more information, please see the related press release ^[6] from Celgene.

Order Of Velcade And Revlimid Treatment May Not Matter In Treating Myeloma – Results from a recent retrospective study indicate that multiple myeloma patients benefit equally whether they are treated with Velcade ^[7] (bortezomib) before Revlimid, or vice versa. However, patients with kidney disease tend to benefit from earlier use of Velcade-based therapies. Both Revlimid- and Velcade-based therapies have become common treatment options for myeloma patients. The investigators of this study were interested in de­ter­min­ing whether one drug should be given before the other. In their analysis, which was based on data for 208 myeloma patients treated between 2003 and 20089, the authors adjusted for a number of potential biases, such as patient age, number of previous therapies, and whether or not a patient had received a stem cell transplant.  The researchers found no significant difference in median overall survival between patients who received Revlimid first versus those who received Velcade first. For more information, please refer to the study in the journal Leukemia Research ^[8] (abstract).

Unrelated Donor Stem Cell Transplant May Be An Under-Utilized Treatment Option For Myeloma – Find­ings from a retrospective study suggest that donor stem cell transplants using cells from unrelated donors may be underutilized for myeloma patients, particularly older myeloma patients. Specifically, the researchers found that only 11 percent of the myeloma patients they estimated to be eligible for an unrelated donor trans­plant actually underwent the procedure. Reasons for not undergoing a transplant included not being referred to a transplant center, worsening health condition of the patient, a prolonged search for a suitable donor, and financial issues. Donor (allogeneic) stem cell transplants involve infusing a patient with donor stem cells after high-dose chemotherapy. While the procedure has the potential to cure myeloma, it also is often accompanied by serious complications, including graft-versus-host-disease (GVHD), in which donor im­mune system cells recognize the patient's cells as foreign and attack them. For more information, please re­fer to the study in the journal Biology of Blood and Marrow Transplantation ^[9] (ab­stract).