The combination therapy of cyclophosphamide, thalidomide (Thalomid) and dexamethasone (Decadron), commonly referred to as CTD, is effective and well tolerated in newly diagnosed multiple myeloma patients, according to a new study published in the journal Clinical Lymphoma, Myeloma & Leukemia. Patients who underwent autologous stem cell transplantation (ASCT) after CTD therapy had higher success rates and longer survival.

Currently, thalidomide plus dexamethasone is one of the standard treatments for newly diagnosed myeloma patients. However, this treatment is associated with a high rate of blood clotting in the deep veins …

A recent paper published in the Journal of Clinical Oncology updated the outcomes of multiple myeloma trials conducted by the Intergroupe Francophone du Myelome, the Southwest Oncology Group, and the University of Arkansas for Medical Sciences.

The update provides a fuller, long-term picture of the advantages of some of the autotransplant regimens being tested. It represents the first international effort at systematically updating previously reported trial results, which had indicated that autotransplantation with high-dose melphalan (Alkeran) therapy significantly extends the survival of multiple myeloma patients.

Autologous stem cell transplantation, or autotransplantation, …

Patients who do not respond at least partially to treatment with Revlimid (lenalidomide) or thalidomide (Thalomid) prior to a stem cell transplant may have significantly shorter survival times, according to a recent study published in the journal Blood.

Currently, the standard treatment plan involving stem cell transplantation begins with induction therapy, which decreases the number of abnormal cells and proteins in a patient’s bone marrow before collection of stem cells for the transplant. Next, patients undergo high-dose chemotherapy and transplantation, after which, some patients receive consolidation or maintenance therapy.

Past …

In its latest version of guidelines for multiple myeloma treatment, the National Comprehensive Cancer Network (NCCN) recommended the use of Revlimid (lenalidomide) as a maintenance therapy after stem cell transplantation. The NCCN based their decision on the preliminary findings of three Phase 3 trials: MM-015, CALGB 100104, and IFM 2005-02.

“[Revlimid] as maintenance has been evaluated in three independent randomized clinical trials. Results from each of these trials show improvements in time-to-progression,” the NCCN myeloma guidelines state. “The panel felt that this warranted inclusion; however, this recommendation remains Category 2A …

Phil Brabbs, a software product manager and former kicker for the University of Michigan football team, was diagnosed with smoldering multiple myeloma the day after his 28th birthday. “At 28, looking at my son who was two, you think, ‘Will this kid ever remember me?’ It was really frightening,” he said.

“To get a cancer diagnosis when it seems like you’re doing everything right – you don’t smoke, you drink modestly, you exercise – it was quite shocking. But I don’t think it took more than a week or two for me …

The results of a recent Phase 3 clinical trial indicate that treatment with high-dose melphalan (Alkeran) prior to a stem cell transplant results in a longer period of remission for myeloma patients than treatment with reduced-intensity melphalan. The differences in remission duration were larger for patients younger than 60 years old.

Based on the significant difference in progression-free survival between the two treatment groups, the researchers concluded that high-dose (200 mg/m²) melphalan is more effective in preparing younger, medically fit multiple myeloma patients for stem cell transplants. However, reduced-intensity (100 mg/m²) …

Dr. Robert Kyle, a leading myeloma physician, researcher, and professor at the Mayo Clinic, spoke with The Myeloma Beacon about his approach to treating multiple myeloma patients; participation in clinical trials; many of the key issues for myeloma patients and physicians, including conventional and alternative treatment options; and the future of personalized medicine.

This article is the second part of a two-part series based on the Beacon’s conversations with Dr. Kyle. It will cover the role of clinical trials and key issues in the treatment of multiple myeloma as well as promising …