Articles tagged with: Peripheral Neuropathy
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Itraconazole May Increase The Risk Of Early Peripheral Neuropathy In Myeloma Patients Receiving Velcade – Results of a recent Japanese study indicate that itraconazole (Sporanox), a medication used for the treatment of fungal infections, may increase a multiple myeloma patient’s risk of developing peripheral neuropathy during their first Velcade (bortezomib) treatment cycle. Peripheral neuropathy is a common side effect of Velcade that is characterized by pain and tingling in the extremities due to nerve damage. Based on their findings, the researchers recommend that the use of itraconazole should be avoided in patients receiving Velcade. For more information, please see the study in The International Journal of Hematology.
Myeloma Patients With Residual Disease After Initial Therapy May Require Additional Therapy Shortly After Transplant – French researchers recently evaluated the levels of myeloma cells and normal plasma cells seven days after stem cell transplantation for newly diagnosed multiple myeloma. Among patients who showed no residual myeloma cells after initial therapy, the researchers found that levels of myeloma cells remain undetectable seven days after stem cell transplantation. In addition, normal plasma cell levels increased threefold within seven days after stem cell transplantation in these patients. By comparison, among patients who showed residual myeloma cells after initial therapy, levels of myeloma cells were reduced but not eradicated seven days after stem cell transplantation. Normal plasma cell levels did not increase in these patients. Based on their findings, the researchers recommend that patients with residual disease receive additional therapy shortly after transplantation to kill off the remaining myeloma cells. For more information, please see the study in Oncotarget.
FLC Ratio May Be A Good Prognostic Marker For Progression From Smoldering To Active Myeloma – Researchers at the Mayo Clinic recently found that the free light chain (FLC) ratio may be a good prognostic marker for smoldering myeloma patients who are at high risk of progressing to active myeloma. The FLC assay is one of the standard blood tests used to diagnose multiple myeloma. Specifically, the researchers found that smoldering myeloma patients with a FLC ratio of 100 or higher progressed to active myeloma within a median of 15 months, compared to 55 months for smoldering myeloma patients with FLC ratio below 100. Based on their findings, the researchers recommend that smoldering myeloma patients with a FLC ratio of 100 or higher be treated early. For more information, please see the study in the journal Leukemia (abstract).
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ALT-801 Phase 1/2 Clinical Trial Is Enrolling Relapsed Or Refractory Myeloma Patients - The Florida-based biopharmaceutical company Altor Bioscience has started a Phase 1/2 clinical trial of its investigational drug ALT-801. The trial is being conducted at the University of Iowa and is recruiting myeloma patients who have had at least two previous treatment regimens. ALT-801 is a protein that triggers immune cells to attack cancer cells. The drug also is being explored as a potential treatment for melanoma and bladder cancer. For more information, see the clinical trial description and information about ALT-801 at the Altor website.
Study Supports Use Of Once-Weekly Velcade – Results from a recent retrospective Chinese study support previous findings that once-weekly Velcade (bortezomib) is similar to twice-weekly Velcade in terms of efficacy and safety. Similar results were first found in 2010 during a study of Velcade in combination with melphalan (Alkeran), prednisone, and thalidomide (Thalomid). The results from that study showed that once-weekly Velcade was as effective as twice-weekly Velcade and that patients who received Velcade once a week experienced fewer side effects, especially peripheral neuropathy (pain, tingling, or loss of sensation in the extremities), a common side effect of Velcade (see related Beacon news). The current study found that overall response rates were similar for patients treated with once-weekly (77 percent) or twice-weekly Velcade (75 percent) in combination with dexamethasone (Decadron). In addition, the median progression-free survival was similar in both groups (8 months versus 10 months, respectively). Side effects were more common among patients treated twice a week; however, the differences were not statistically significant. In particular, 31 percent of patients treated with once-weekly Velcade developed neuropathy as compared to 50 percent of patients treated with twice-weekly Velcade. For more information, please see the study in the Journal of Huazhong University of Science and Technology (abstract).
Age And Platelet Count May Predict Ability To Collect Enough Stem Cells For Transplant – Findings from a recent study show that age and platelet count can be used to predict whether a multiple myeloma patient is likely to successfully harvest enough stem cells for a transplant. Patients older than 58 years or who had a baseline platelet count less than 161,000 cells/mm3 failed to collect enough stem cells using granulocyte colony-stimulating factor (G-CSF) to mobilize the stem cells into the blood for collection. The study investigators conclude that patients with these characteristics should not receive mobilization with G-CSF alone and that alternative methods of mobilization should be tested. For more information, please see the study in Transfusion and Apheresis Science (abstract).
Treatment-Free Intervals Improve Quality Of Life For Multiple Myeloma Patients – A recent survey of multiple myeloma patients in the United Kingdom shows that patients in their first treatment-free interval and those experiencing a longer treatment-free interval enjoy better quality of life as compared to patients in other phases of treatment. The investigators believe these results may help doctors and patients make treatment decisions, especially when considering extended treatment plans. For more information, please refer to the study in Supportive Care in Cancer (abstract).
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High Levels Of Interleukin-16 Found In Multiple Myeloma Patients – German researchers recently found that a protein called interleukin-16, which helps regulate the growth of normal white blood cells, is overproduced in the bone marrow of multiple myeloma patients. They also found that they could slow the growth of myeloma cells in the laboratory by 80 percent when they prevented the cells from producing interleukin-16. Based on their findings, the researchers suggested that interleukin-16 may be a basis for new diagnostic or prognostic tests or treatments. For more information, please see the study in the Journal of the National Cancer Institute (abstract) and a 2004 study (abstract) that also investigated interleukin-16's role in myeloma.
Pre-Existing Diabetes Negatively Impacts Prognosis Of Multiple Myeloma Patients – A recent study found that multiple myeloma patients with pre-existing diabetes have lower survival rates than patients without diabetes. The study also found that such patients were more likely to have kidney problems and advanced multiple myeloma at the time of diagnosis. In addition, they were less likely to receive bisphosphonates for myeloma-related bone disease. For more information, please see the study in the European Journal of Haematology (abstract).
Quality Of Life Decreases After Multiple Myeloma Diagnosis For Majority – A recent survey conducted in the Netherlands shows that within one year of diagnosis, the majority (74 percent) of multiple myeloma patients report a decrease in quality of life. In addition, patients reported that the most bothersome symptoms within the past week included tingling in the hands/feet (peripheral neuropathy), back pain, bone pain, arm/shoulder pain, and feeling drowsy. In a recent Myeloma Beacon poll, peripheral neuropathy and fatigue, followed by pain, were mentioned as the most life-altering side effects of myeloma treatment. For more information, please see the study in the European Journal of Haematology (abstract) and the Beacon poll on life-altering side effects.
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Subcutaneous Velcade Gets Positive Opinion From European Advisory Committee – An advisory committee of the European Medicines Agency (EMA) has granted a positive opinion recommending European approval of subcutaneous Velcade (bortezomib). The committee’s decision was based on results of a Phase 3 study demonstrating that subcutaneous Velcade is as effective as intravenous Velcade but associated with fewer and less serious side effects. Updated, longer-term results of the Phase 3 study were recently published in the journal Hematologica (abstract). The EMA is expected to decide whether or not to approve subcutaneous Velcade within 30 to 60 days. For information, see the press release from Janssen-Cilag, the company that markets Velcade in Europe.
Oxycontin May Reduce Peripheral Neuropathic Pain After Velcade Treatment – Results from an Italian study suggest that treatment with the pain medication Oxycontin (controlled-release oxycodone) may help control Velcade-induced peripheral neuropathic pain that is unresponsive to other pain killers. The 62 myeloma and lymphoma patients who participated in the study reported an average reduction in pain intensity from 7.6 to 1.3 (on an 11-point rating scale) after two weeks of Oxycontin treatment. The frequency of brief pain was also reduced with Oxycontin treatment. About 75 percent of the study participants found the treatment very effective or effective; 51 percent experienced slight or mild side effects. For more information, see the related journal article in Supportive Care in Cancer (abstract).
Ibrutinib (PCI-32765) Shows Activity Against Multiple Myeloma – Results from a preclinical study suggest that the investigational drug ibrutinib (PCI-32765) is active in multiple myeloma. Ibrutinib blocks activity of an enzyme called Bruton’s tyrosine kinase (Btk). Btk is present both in antibody-producing cells and in cells called osteoclasts that remove bone tissue. Ibrutinib, which is being developed by the California-based biotech company Pharmacyclics together with Johnson & Johnson, is being investigated as a potential treatment for a number of different blood cancers. Two Phase 3 clinical trials of the drug in leukemia and lymphoma patients are about to start, and a Phase 2 trial in myeloma patients is ongoing. For more information, see the preclinical study results in the journal Blood (abstract) and the clinical trial description for the Phase 2 myeloma trial.
Blood Calcium Levels May Be An Independent Prognostic Factor In Multiple Myeloma – Results from a small Mexican study suggest that calcium levels in the blood may be an independent predictor of overall survival in multiple myeloma patients. Blood calcium levels typically rise during multiple myeloma, as loss of bone structure releases calcium into the blood. In this study, researchers compared the levels of hemoglobin, platelets, calcium, and a wide range of enzymes and proteins in the blood of healthy individuals and multiple myeloma patients. The level of calcium in a myeloma patient's blood was the only factor that, on its own, correlated with overall survival. For more information, please see the study in Revista de investigación clínica (abstract).
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Today is the last day of this year’s American Society of Clinical Oncology (ASCO) annual meeting, which is being held in Chicago. However, the multiple myeloma-related presentations at the meeting concluded yesterday.
A poster session yesterday afternoon featured research on a wide variety of myeloma-related topics, ranging from new treatments being developed for myeloma, to currently used regimens, to second cancers, to precursor myeloma diseases, and much more.
This article summarizes research from that session related to prognostic factors, precursor myeloma diseases, peripheral neuropathy, osteonecrosis of the jaw, and second cancers.
A summary …
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A group of multiple myeloma experts from the International Myeloma Working Group recently published a review of management strategies for drug-induced peripheral neuropathy in patients with multiple myeloma.
This Beacon article, the third in a three-part series, summarizes the experts’ recommendations for prevention of peripheral neuropathy as well as future steps toward better management of the condition.
The first article in the series describes peripheral neuropathy and summarizes the symptoms of drug-induced neuropathy as well as the risk of developing neuropathy associated with myeloma therapies. The second article summarizes …
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A group of multiple myeloma experts from the International Myeloma Working Group recently published a review of management strategies for drug-induced peripheral neuropathy in patients with multiple myeloma.
This Beacon article, the second in a three-part series, summarizes the experts’ recommendations for the treatment of drug-induced peripheral neuropathy.
The first article in the series describes peripheral neuropathy and summarizes the symptoms of drug-induced neuropathy as well as the risk of developing neuropathy associated with myeloma therapies. A third article will summarize the experts’ recommendations for prevention of peripheral neuropathy as …