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 …

Multiple myeloma patients in England and Wales will now be able to receive Revlimid (lenalidomide) as a treatment option under the National Health System (NHS) after an agreement was reached between NHS and Celgene, the maker of Revlimid.

The news comes after Celgene proposed a new cost-sharing plan where the NHS will pay for the first two years of treatment, and Celgene will pick up the bill for any further treatment. It is estimated that approximately 17 percent of myeloma patients treated with Revlimid will require treatment after two years. …

Numerous treatment options are available to multiple myeloma patients, with the therapeutic objective of inducing complete remission (CR) or at least very good partial remission (VGPR).

In the American Society of Hematology's recent Education Program Book, "Hematology," researcher Jean-Luc Harousseau compares treatment regimens with and without a stem cell transplant component. In addition, he examines the mounting belief that complete remission, a potentially unreliable prognostic indicator, should cease to be the therapeutic goal in all situations.

Comparison: Treatment With and Without Stem Cell Transplant

During initial treatment after …

For more than four decades, the standard of care in elderly multiple myeloma patients over age 65 has been a combination of melphalan (a chemotherapy drug) and prednisone (a steroid). Yet, this regimen, known as MP, only achieves a five percent complete remission rate.

The advent of novel therapeutic agents has greatly improved treatment outcomes.

Multiple researchers have tested an MP plus thalidomide (Thalomid) regimen, or MPT, and the majority of these studies have found that MPT yields superior complete remission (CR), very good partial remission (VGPR), and progression-free survival rates, …

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, …

The health care system in the United Kingdom is making more treatment options available to terminally ill patients.

In England and Wales, the National Institute for Health and Clinical Excellence (NICE) decides which treatments will be made available under the state-funded National Health Service.  Until recently, NICE refused to approve the use of any drug costing more than £30,000 ($44,000) for each extra year of good health attributable to the drug.

On January 2, NICE issued new guidelines to approve, under certain circumstances, life-extending drugs that cost as much as £80,000 ($118,000) …

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 …