At the XII International Myeloma Workshop held last month, physicians discussed induction therapy for patients who are not eligible for stem cell transplants.

Induction therapy is the initial treatment given to patients to reduce the number of cancer cells, usually given prior to subsequent treatments. For patients ineligible for transplants, such as the elderly, induction therapy has historically consisted of administering the drugs melphalan and prednisone, but this has changed considerably in recent years.

A number of clinical trials have investigated the combination of melphalan and …

Physicians discussed upfront and induction therapy at the XII International Myeloma Workshop (IMW) last month. During their discussion, they focused on stem cell transplantation as an early treatment method for eligible multiple myeloma patients.

The concepts of upfront and induction therapy are very similar. Upfront therapy is any therapy given to previously untreated patients, while induction therapy is defined as the first treatment toward reducing the number of cancer cells in a patient before subsequent treatments. Therefore, this IMW discussion focused on the very first steps doctors take during treatment of multiple …

As Revlimid (lenalidomide) and Velcade (bortezomib) have become standard therapies in the treatment of multiple myeloma, managing side effects is important for patients who want to maintain their treatment while minimizing toxicity.

A recent report published in the journal Community Oncology discusses the management of side effects associated with these agents. Overall, the most commonly observed toxic effects include myelosuppression, gastrointestinal effects, peripheral neuropathy, and thromboembolic events.

Myelosuppression is a condition in which bone marrow activity is decreased, resulting in fewer red blood cells, white blood cells, and platelets. Revlimid …

A recent paper published in Lancet Oncology examines drugs that target biological mechanisms in multiple myeloma. This article is the second of three articles discussing new drugs for myeloma treatment.

Researchers have begun to understand the multi-step process by which myeloma occurs. Key features of this process are signaling pathways, which take information from outside of the cell and from within the cell to create a cascading reaction. While signaling pathways are a part of all cells, they are problematic if not regulated.

Studies have shown that a pathway involving the NFkB …

Palonosetron, a second-generation 5-HT3-receptor antagonist, is at least as effective as Kytril (granisetron), a first-generation 5-HT3-receptor antagonist, in preventing nausea and vomiting due to chemotherapy up to one day after treatment.  One to five days after treatment, palonosetron remains effective in a significantly larger percentage of patients than does Kytril.

Many chemotherapy patients are subject to vomit-inducing anticancer treatment, which typically contains the drugs cisplatin or anthracycline/cyclophosphamide.  The standard preventative treatment, Kytril, works in just over 50% of patients when administered with dexamethasone prior to chemotherapy.  However, the effect wears …

Steroids such as dexamethasone and prednisone are frequently used to treat myeloma patients. They reduce swelling and inflammation and have been shown to kill myeloma cells. However, steroids can also cause many serious side effects.

Both dexamethasone and prednisone can be prescribed alone or in combination with novel anti-myeloma drugs, which include thalidomide (Thalomid), Revlimid (lenalidomide), and Velcade (bortezomib). Prednisone is also used to enhance the response rate of melphalan therapy in myeloma patients.

Side effects caused by these steroids include, but are not limited to, …

Two Phase 2 studies presented at this year's ASH conference show that a new treatment regimen achieves 86 percent to 98 percent responsiveness in relapsed/refractory and newly diagnosed multiple myeloma patients.

Known as Rev/Vel/Dex, the treatment is a cocktail of three commonly prescribed multiple myeloma drugs -- Revlimid (lenalidomide), Velcade (bortezomib), and dexamethasone. Both studies started patients on the same maximum dosage of 25 mg Revlimid, 1.3 mg/m² Velcade, 20 mg dexamethasone, and dosages were adjusted according to individual responses.

Both relapsed/refractory and newly diagnosed patients responded comparably in …