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Results from a small retrospective analysis conducted in Japan indicate that injection site reactions from subcutaneous (under the skin) injections of Velcade (bor­tezo­mib) are more likely to occur during the first cycle of treatment than in later cycles.

A third of patients in the study developed injection site re­ac­tions – such as swell­ing, redness, or itchi­ness – during the first cycle of treatment.  However, the share of patients experiencing such reactions dropped to one fifth during later cycles.

In the Japanese study, investigators retrospectively analyzed data from 20 multiple myeloma patients with a median age of 72 years who were newly diagnosed (60 percent) or had relapsed/refractory disease (40 percent).

Overall, 65 percent of patients developed injection site reactions at some point during their subcutaneous Velcade treatment.

The Japanese researchers found that the rate of injection site reactions was significantly higher during the first treatment cycle compared to subsequent cycles (34 percent versus 20 percent, respectively).

The rate of moderate or severe injection site reactions was also significantly higher during the first cycle compared to subsequent cycles (16 percent versus 1 percent, respectively).

Injections in the abdomen caused fewer moderate or severe injection site reactions (2 percent), compared to injections in the thigh (11 percent).

According to the researchers, the higher rates seen with injections to the thigh may be due to the fact that the thigh contains less fat tissue than the abdomen.

The researchers note that stage of disease and patient weight had no impact on the rate or severity of the injection site reactions.

Based on their findings, they recommend better management of injection site reactions, particularly among patients who receive injections in their thigh during their first treatment cycle.

They add that treatment with corticosteroids may prevent, or provide relief from, injection site reactions.

For more information, please refer to the study in the International Journal of Hematology (abstract).

NewsFlash »

Fewer Injection Site Reactions With Subcutaneous Velcade Administered To The Abdomen Instead Of The Thigh - Japanese researchers recently found that subcutaneous (under the skin) injections of Velcade (bortezomib) in the abdomen cause fewer injection site reactions compared to injections in the thigh. According to the Japanese researchers, the higher rates seen with injections to the thigh may be because the thigh contains less fat tissue than the abdomen. Based on their findings, they recommend administering subcutaneous Velcade to the abdomen, particularly in the case of thin patients. For more information, please see the study in The European Journal of Haematology (abstract).

Cereblon Levels May Affect Effectiveness Of Thalidomide – Results of a European retrospective analysis indicate that levels of the protein cereblon in patients’ myeloma cells may impact the efficacy of thalidomide (Thalomid). The researchers found that newly diagnosed multiple myeloma patients with high cereblon levels who received thalidomide maintenance had longer progression-free survival times than those with low cereblon levels. The researchers did not observe any association between cereblon levels and the effectiveness of Velcade maintenance therapy. Previous studies have shown that cereblon is necessary for the immunomodulatory drugs -- particularly Revlimid (lenalidomide) and pomalidomide -- to be effective against multiple myeloma (see related Beacon news article). For more information, please see the study in the journal Blood (abstract).

Latest Findings Show Kepivance May Not Decrease Mouth Ulcers In Myeloma Patients Undergoing High-Dose Chemotherapy – In contrast to previous findings, results from a recent Dutch study show that Kepivance (palifermin) has no effect on mouth ulcers in multiple myeloma receiving high-dose melphalan (Alkeran) prior to stem cell transplantation using their own stem cells.  In the Dutch study, patients who received Kepivance had similar rates of mouth ulcers as patients who received a placebo. For more information, please see the study in the journal Bone Marrow Transplant (abstract).

Study Finds Association Between Myeloma And Certain Occupations – Results of another European analysis suggest that farmers, cleaning workers, and, to a certain extent, printers have an increased risk of developing multiple myeloma. The European researchers also found that pesticide exposure over a period of 10 years or more increased the risk of developing multiple myeloma. For more information, please see the study in the Journal of Occupational Medicine and Toxicology (pdf, full text).