Articles tagged with: Cyclophosphamide
Opinion»
In September 2015, after three months of induction with Revlimid (lenalidomide), Velcade (bortezomib), and dexamethasone (Decadron), my IgA heavy chain M-spike had fallen from 6.5 g/dL (65 g/L) to zero. My doctor felt that the time was right to get onto the next phase of treatment – a stem cell transplant.
I remember being apprehensive, but actually quite excited at the same time, as this procedure seemed to be the door to a real chance of remission and – with luck – many years of good health …
News»
Good morning, myeloma world.
We've got a lot of new myeloma-related research to cover today, so we'll get right down to business.
The first two studies we will review are related to autologous (own) stem cell transplantation.
One study looks at whether myeloma cells make their way into the infusion of a patient's own stem cells that a patient gets during the autologous transplant process. The study finds that, in some cases, myeloma cells do make it into the stem cell infusion, and when this happens, it could – again, could – …
News, Opinion»
The 2014 International Myeloma Working Group (IMWG) Annual Summit took place in Milan, Italy on June 9 and 10.
The summit is a special meeting organized by the International Myeloma Foundation in which leading myeloma researchers get to brainstorm collectively about the most pressing issues in the field, find ways to collaborate, and plan future laboratory and clinical studies.
The IMWG summit is hailed by most attendees as the most important meeting for myeloma researchers worldwide. It is a unique opportunity for investigators in the field to engage in lively debate but, …
NewsFlash »
Findings from a recent retrospective study conducted in Korea indicate that a combination of dexamethasone, cyclophosphamide, etoposide, and cisplatin may be a suitable bridging therapy for relapsed multiple myeloma patients who previously received treatment with novel agents.
Most patients responded to the combination as salvage therapy or achieved stable disease, but the response rates were not durable. Therefore, the researchers suggested that the combination might serve better as bridging therapy - to stabilize the myeloma until the patients receive further treatment, such as stem cell transplantation or access to investigational therapies in clinical trials.
These results are particularly relevant for multiple myeloma patients in countries where access to novel agents, such as thalidomide (Thalomid), Velcade (bortezomib), and Revlimid (lenalidomide), is restricted, and also patients for whom novel agents no longer work.
The retrospective analysis was based on data from 59 patients who received dexamethasone (Decadron), cyclophosphamide (Cytoxan), etoposide (VP-16), and cisplatin, commonly referred to as DCEP, as salvage therapy between 2006 and 2013. The median patient age was 58 years, and patients had received a median of three prior therapies, including at least one novel agent such as thalidomide, Revlimid, or Velcade.
Overall, 45 percent of patients responded to the treatment, with 2 percent achieving a complete response, 2 percent a very good partial response, and 41 percent a partial response. An additional 16 percent of patients achieved a minor response and 20 percent had stable disease.
The median progression-free survival was 3.7 months and the median overall survival was 8 months, which according to the researchers indicate that a durable response is hard to achieve with this regimen. Based on these findings, the researchers conclude that DCEP may be more suitable as a bridging therapy by stabilizing the disease for the next treatment.
The most common severe side effects were blood-related and included low white blood cell counts (92 percent), low platelet counts (76 percent), and low red blood cell counts (71 percent). Overall, 62 percent of patients discontinued treatment due to side effects.
The treatment-related death rate was notable at 15 percent. Nearly all of the treatment-related deaths were due to infection in patients with low white blood cell counts.
The researchers therefore recommend that patients being treated with DCEP also receive growth factors to increase blood cell counts and reduce the chance of infection.
For more information, please refer to the study in the Annals of Hematology (abstract).
News»
Monday was the third day of this year’s meeting of the American Society of Hematology (ASH). The day was filled with oral presentation sessions from early in the morning until into the evening.
In the afternoon and early evening, there were six oral presentation sessions devoted solely to multiple myeloma and a number of other myeloma-related presentations scattered about the afternoon. The topics of these presentations ranged from the biology of myeloma to treatment options for newly diagnosed, relapsed and refractory, and older patients.
This ASH update highlights most of the oral …
News»
Results from a recent Italian Phase 1/2 clinical trial indicate that the combination of Pomalyst, cyclophosphamide, and prednisone is effective and safe in relapsed and refractory multiple myeloma patients.
Overall, 51 percent of patients in the trial responded to the treatment, and the median progression-free survival time was 10.4 months. The median overall survival had not been reached yet; however, 69 percent of patients were alive one year after starting treatment.
The study participants had previously been treated with a median of three prior therapies, and all had received prior treatment with
NewsFlash »
Stem Cell Mobilization With Cyclophosphamide And G-CSF Is More Effective And Less Expensive Than Mozobil And G-CSF – Findings from a recent study show that cyclophosphamide (Cytoxan) plus granulocyte colony-stimulating factor (G-CSF) is more effective than Mozobil (plerixafor) plus G-CSF as a stem cell mobilization therapy for multiple myeloma patients. Both Mozobil and cyclophosphamide increase the number of stem cells that can be harvested during collection. Patients in the recent study who received the cyclophosphamide-G-CSF combination collected significantly more stem cells than patients who received Mozobil plus G-CSF (16.6 × 106 cells/kg versus 11.6 × 106 cells/kg). In addition, the investigators found that the total cost of stem cell mobilization was less with cyclophosphamide plus G-CSF than with Mozobil plus G-CSF. However, cyclophosphamide plus G-CSF was associated with significantly higher rates of side effects, antibiotic use, and hospitalization. For more information, please see the study in Bone Marrow Transplantation (abstract).
Psychosocial Support May Be Appropriate For Newly Diagnosed Myeloma Patients - Results from a German study indicate that about half of newly diagnosed multiple myeloma patients desire psychosocial support soon after their diagnosis. Psychosocial support includes services intended to help a myeloma patient with the psychological, emotional, social, and practical effects of their diagnosis and treatment. Of the 114 myeloma patients included in the study, 51 percent desired psychosocial support, with depressed and younger patients having the greatest interest. Specifically, patients were most interested in relaxation techniques (21 percent), psychological counseling (20 percent), and peer support groups (18 percent). At the time of diagnosis, 24 percent of patients reported signs of depression and 8 percent reported signs of anxiety. Based on their findings, the researchers recommend that a variety of different types of psychosocial support be offered to myeloma patients at the time of diagnosis. For more information, please refer to the study in the journal Psycho-Oncology (abstract).
Preclinical Study Indicates Melphalan-Flufenamide May Be Effective In Multiple Myeloma – Results from a preclinical study indicate that a new melphalan-based treatment may be effective for multiple myeloma. The treatment, known as melphalan-flufenamide or J1, is being developed by the Swedish pharmaceutical company Oncopeptides and consists of melphalan (Alkeran) bound to flufenamide. The drug only becomes active once it enters a cell and melphalan is released from flufenamide. Cancer cells more efficiently activate the drug, increasing the concentration of melphalan in cancer cells compared to healthy cells. Specifically, the results showed that melphalan-flufenamide effectively killed myeloma cells that were resistant to Velcade (bortezomib) and melphalan alone. The researchers found that even low doses of melphalan-flufenamide were effective and should be safer than the doses of melphalan current used to treat myeloma. For more information, please refer to the study in Clinical Cancer Research (abstract).
Clinical Trial To Study WT1 Vaccine In Multiple Myeloma Patients – The Memorial Sloan-Kettering Cancer Center has launched a pilot trial to study the Wilms Tumor 1 (WT1) vaccine in multiple myeloma patients who just received a stem cell transplant. WT1 is a protein that is often present in myeloma cells. The goal of the study is to determine whether the vaccine activates the patient’s immune system against myeloma cells with WT1. Eligible patients must be at least 18 years old, have WT1-positive myeloma, and be eligible to undergo an autologous stem cell transplant. For more information on the trial, please see the clinical trial description.