As the myeloma community continues to investigate whether stem cell transplantation or novel agents is the best way to treat newly diagnosed myeloma patients, recent results from a Phase 3 clinical trial indicate that stem cell transplantation may lead to longer disease-free survival.

The results from this study show that more multiple myeloma patients who received a stem cell transplant were alive and disease-free after 24 months compared to patients treated with Revlimid in combination with conventional chemotherapy.

The transplanted patients, however, also experienced more severe side effects compared to non-transplanted patients. …

Thursday was the third day of the Inter­na­tional Myeloma Workshop (IMW) in Paris.  There were pre­sen­ta­tions from early morn­ing through the evening.

Some of the highlights from the first part of Day 3 of the conference are summarized in this article.  Highlights from the sec­ond part of the day are summarized in a separate article (see re­lated Beacon news).

Treating Older, Newly Diagnosed Myeloma Patients

The first session of the morn­ing was about treating newly diag­nosed mul­ti­ple myeloma patients over the age of 65 years, spe­cif­i­cally those who are in­eli­gible for …

High-dose melphalan continues to be the gold standard regimen for multiple myeloma patients prior to autologous stem cell therapy, according to a recent review of research investigating alternative preparative treatments before stem cell transplantation. 

The authors of the review pointed out, however, that current research on variations of this regimen may provide improved transplantation response rates for myeloma patients in the future. 

High-dose chemotherapy prior to stem cell transplantation, often called a preparative or conditioning regimen, is administered with the intention of eliminating cancerous cells from the patient’s bone marrow. High-dose chemotherapy …

The use of mitoxantrone and melphalan prior to stem cell transplantation in multiple myeloma patients results in favorable survival rates and manageable side effects, according to the results of a Phase 2 clinical trial.

Although the results of the study are encouraging and confirm the results of previous trials, Dr. Anne Beaven, from Duke University Medical Center and lead author of the study, noted that the trial was conducted before the introduction of novel agents into routine clinical practice.

“Until a trial is performed combining this regimen with maintenance Revlimid (lenalidomide) …

Results of a recent study suggest that a single dose of Velcade given after high-dose melphalan results in better outcomes in newly diagnosed multiple myeloma patients after stem cell transplantation than a single dose of Velcade given before high-dose melphalan.  Side effects of the regimen with Velcade were similar to those seen with melphalan alone.

Treatment with high-dose chemotherapy followed by stem cell transplantion is a standard therapeutic approach for younger, newly diagnosed multiple myeloma patients.  High-dose chemotherapy prior to stem cell transplantation, often called a conditioning regimen, is administered with the …

Newly diagnosed multiple myeloma patients who achieved a complete response to the combination of Velcade, melphalan, and prednisone experienced longer time to disease progression, time to next therapy, and treatment-free interval compared to patients who achieved a partial response. 

The benefits associated with complete response were similar regardless of whether complete response was achieved early or late in the treatment course.

Based on these findings, the researchers concluded that the achievement of a complete response should be considered an important treatment goal. They recommended that VMP be continued in patients tolerating therapy, …