Triple therapy for Multiple Myeloma

9 03 2015

A global analysis shows benefits never before seen with triple pharmacological therapy for multiple myeloma.


In the treatment of the multiple myeloma, the addition of carfilzomib to currently accepted two-drug combination showed significantly better results than the application of only two drugs, He says a global research team led by scientists at Mayo Clinic.


The results were reported by internet the 6 December in the New England Journal of medicine (New England Journal of Medicine) and presented the 7 of December at the annual meeting of the American Society of Hematology (ASH, for its acronym in English) held in San Francisco.

Preliminary analysis of the clinical trial ASPIRE, who registered to 792 patients with relapse of myeloma multiple and from from 20 countries, He discovered an extension "never before" time view in which patients were free of all disease progression, says the study's principal investigator, Dr. Keith Stewart, oncologist of Mayo Clinic in Arizona. "Patients receiving all three drugs, of carfilzomib, lenalidomide and dexamethasone, did not show any progression of the disease for an average of 26 months", Adds doctor. "Never have I had reported anything in relapse of multiple myeloma".

Scientists discovered that carfilzomib to be added to the standard treatment (lenalidomide and dexamethasone) resulted in a referral 8,7 months long, What is it 50 percent higher than the one obtained with the normal combination of the two drugs (26,3 months to 17,6 months).

The number of patients who responded to treatment was also significantly increased with the addition of carfilzomib to normal therapy: 87,4 por ciento frente a 66,9 por ciento. In addition, After treatment with three drugs, the disease was undetectable at more than triple the patients (31,8 por ciento frente a 9percent versus Stewper cent out that, Despite the preliminary results, also there was a trend towards improved overall survival. "It is also important to note that patients receiving triple therapy reported better quality of life, Despite the increased intensity of the treatment", Adds.

These results highlight the growing success in the treatment of myeloma, the second most common type of blood cancer, says Dr. Stewart.

"The survival of multiple myeloma has nearly doubled in the last decade and as positive results of the implementation of the triple therapy possibly further improve it", refine your doctor. "It's a good topic to talk about".

Lenalidomide is a potent derivative of Thalidomide that affects the function of the immune system. Dexamethasone is a steroid. Carfilzomib is an inhibitor of the proteasome to in 2012 It received authorization from the administration of food and Drug Administration United States (FDA, for its acronym in English) for its application in patients with multiple myeloma advanced and terminal. The drug is specifically directed towards the regulation of proteins which nourish the growth of multiple myeloma.

The Studio ASPIRE discussed the implementation of the drug in patients less advanced. "There was concern that carfilzomib would increase side effects, especially when used with other two drugs", explains Dr. Stewart.

However, This was not a big problem, Adds doctor. "In reality, It seems that the frequency of the majority of the side effects, including severe toxicity, It was the same in both study groups. To ask patients how they felt, the response obtained practically from day one and throughout the study was reported feeling better with all three drugs. Carfilzomib yielded much better than people expected".

Mayo Clinic is one of the leaders in the clinical investigation of carfilzomib. Due to the experience of researchers at Mayo Clinic both basic and clinical research in the treatment of multiple myeloma, the promoters asked them to conduct phase I of the study on the substance. "We are first world centres in applying this drug and the first with a patient who already responded to it in the year 2006", says Dr. Stewart. The scientists from Mayo Clinic also participated in the studies phase II and received the request for the final clinical trial ASPIRE.

"We hope that the results of this trial will lead to the authorization of this combined therapy in patients with relapse of multiple myeloma in the world", says Dr. Stewart.

Onyx Pharmaceuticals, Inc., subsidiary of Amgen, financed the study.

El Dr. Stewart has offered consultancy to Onyx, but he has not personally received any compensation. El DDrewart has also provided consulting services in Celgene, Novartis, Bristol-Myers Squibb and Sanofi Aventis.


by Duska Anastasijevic



Information about the Cancer Center's may Clinic

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