Articles tagged with: Salvage Therapy
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A recently published study may change the goals many myeloma specialists use to make treatment decisions for newly diagnosed myeloma patients planning on having a stem cell transplant.
The study also has potentially broader implications. Indeed, it may influence ongoing debate on a fundamental controversy about how multiple myeloma, in general, should be treated.
The authors of the new study looked at data for 539 myeloma patients who failed to achieve even a partial response to their initial (induction) treatment regimen after diagnosis.
After their initial treatment failed, some of the 539 patients …
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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).
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A new study provides useful, if somewhat dated, insight into the efficacy and safety of Velcade combined with dexamethasone to treat relapsed or refractory multiple myeloma.
The retrospective study, which was carried out using data from a single center in Italy, included patients who had a median of two previous therapies.
In these patients, the combination of Velcade (bortezomib) and dexamethasone (Decadron) had an overall response rate of 55 percent, and a complete response rate of 19 percent. Median overall survival from the start of treatment was 22 months. …
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Results from a recent retrospective study conducted in Germany suggest that treatment with novel agents followed by an autologous stem cell transplant may be an effective and safe salvage therapy for relapsed multiple myeloma patients who previously received a transplant.
The study investigators believe that this course of treatment could potentially "serve as a bridge" to a late donor transplant in certain patients.
However, the researchers point out that many of the patients included in the analysis did not receive novel agents as initial treatment. It is therefore unclear if similar results …
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Results of a retrospective British study add to the body of research indicating that a second stem cell transplant can be effective salvage therapy for certain relapsed multiple myeloma patients.
The British researchers found that patients who achieved a long remission after their first transplant were more likely to have a long remission after their second transplant. This finding has been seen in previous research on the issue (see related Beacon news articles 1, 2, and 3).
The British investigators also found signs that treatment with Velcade (bortezomib) …
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Findings from a recent retrospective study indicate that a second autologous stem cell transplant may be an effective and safe salvage therapy for certain relapsed and refractory multiple myeloma patients.
In particular, the researchers found that the second stem cell transplant was particularly effective for patients who did not progress for at least 12 months following the first stem cell transplant.
For patients who relapse more quickly, the researchers recommend salvage therapy with novel agents, such as Velcade (bortezomib), thalidomide (Thalomid), Revlimid (lenalidomide), or investigational drugs.
High-dose chemotherapy followed …
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Results from an Italian Phase 1/2 trial show that a combination therapy consisting of lower doses of Velcade, melphalan, and prednisone may be an effective and safe salvage therapy for older multiple myeloma patients.
Over half of the patients in the trial responded to the treatment, and according to the study investigators, the treatment was well tolerated, making it a viable treatment option for older myeloma patients.
In Europe, the combination treatment of Velcade (bortezomib), melphalan (Alkeran), and prednisone – commonly referred to as VMP – is often given as initial therapy to …