Thalidomide therapy for multiple myeloma patients may lengthen survival, researchers report

January 14, 2003

ROCHESTER, Minn. -- Nearly one-third of patients with advanced multiple myeloma who had failed current standard therapy of chemotherapy or stem cell transplantation responded to thalidomide for a median duration of nearly one year in a Mayo Clinic study of the effects of thalidomide on myeloma. The findings are reported in the January issue of Mayo Clinic Proceedings.

Many studies in the last three years have determined that thalidomide is effective in the treatment of multiple myeloma, following the initial report by researchers at the University of Arkansas. However, information is limited on how long thalidomide therapy works and on survival rates with such therapy. The Mayo Clinic researchers report on the results of a study that looked at 32 patients with relapsed multiple myeloma.

"Thalidomide is useful in the treatment of patients with relapsed multiple myeloma," said Vincent Rajkumar, M.D., a hematologist at Mayo Clinic and an author of the study. "Our study confirms an earlier report from the University of Arkansas that among patients who respond to therapy, the benefits are not transient, but last approximately one year on average." Studies are now addressing thalidomide's role in combination with other treatments and in earlier stages of the disease.

The researchers note that an estimated 14,600 new patients were diagnosed with myeloma in the United States during 2002 and an estimated 10,800 deaths will be due to myeloma in the same period. The average survival from diagnosis among patients treated with conventional chemotherapy is three to four years. Multiple myeloma, cancer of the bone marrow, remains an incurable cancer despite advances in high-dose chemotherapy and stem cell transplantation therapy. Thalidomide is not currently approved by the U.S. Food and Drug Administration for the treatment of myeloma.

Researchers are looking to thalidomide, as well as other treatments or combinations, to find ways to lengthen the survival of patients with multiple myeloma. Another study in the same issue of the journal reviews the records of all patients in whom multiple myeloma was initially diagnosed at Mayo Clinic Rochester from Jan. 1, 1985, to Dec. 31, 1998, and found the median duration of survival among the 1,027 patients was 33 months and did not improve during this period.

The article reviews its findings of the features of the disease to aid physicians in recognizing and diagnosing it. They found that bone pain and fatigue related to anemia were common.

Despite the lack of improved survival over 13 years, Mayo Clinic researchers say there is reason to believe survival rates in the future will improve significantly because high-dose therapy with stem cell support and new agents for treatment are being introduced.

First, the use of stem cell transplantation has been shown to prolong survival significantly compared with standard-dose chemotherapy. Second, thalidomide has recently shown significant activity in relapsed myeloma, with a median response duration of approximately one year. Third, promising new drugs have shown impressive activity in patients with advanced myeloma. Supportive care has improved for patients with bony lesions, and efforts to develop oral maintenance drug regimens are ongoing.

"These advances, coupled with remarkable strides in the understanding of the biology of the disease, provide considerable hope and optimism for both patients and myeloma researchers," said Robert Kyle, M.D., of Mayo Clinic and an author of the study.
The study was supported by a grant from the National Cancer Institute.

In an editorial in the same issue, Kenneth Anderson, M.D., of the Dana-Farber Cancer Institute in Boston, Mass., notes the progress in the research of multiple myeloma and lauds the research of Dr. Kyle, whose work over more than 25 years has contributed to the understanding of the history and symptoms of multiple myeloma.

The study by Dr. Rajkumar and others was supported in part by grants from the National Cancer Institute in Bethesda, Md., and by the Celgene Corporation of Warren, N.J. Drs. Raphael Fonseca, a hematologist at Mayo Clinic and a researcher on the study, and Rajkumar received Leukemia and Lymphoma Society of America Translational Research Awards, and Dr. Rajkumar is supported by the Goldman Philanthropic Partnerships of Lake Forest, Ill., and the Multiple Myeloma Research Foundation. Mayo Clinic Proceedings is a peer-reviewed and indexed general internal medicine journal, published for more than 75 years by Mayo Foundation, with a circulation of 130,000 nationally and internationally.

Mayo Clinic

Related Chemotherapy Articles from Brightsurf:

Chemotherapy is used to treat less than 25% of people with localized sarcoma
UCLA researchers have found that chemotherapy is not commonly used when treating adults with localized sarcoma, a rare type of cancer of the soft tissues or bone.

Starved cancer cells became more sensitive to chemotherapy
By preventing sugar uptake, researchers succeeded in increasing the cancer cells' sensitivity to chemotherapeutic treatment.

Vitamin D could help mitigate chemotherapy side effects
New findings by University of South Australia researchers reveal that Vitamin D could potentially mitigate chemotherapy-induced gastrointestinal mucositis and provide relief to cancer patients.

Less chemotherapy may have more benefit in rectal cancer
GI Cancers Symposium: Colorado study of 48 patients with locally advanced rectal cancer receiving neoadjuvant chemotherapy, found that patients receiving lower-than-recommended doses in fact saw their tumors shrink more than patients receiving the full dose.

Male fertility after chemotherapy: New questions raised
Professor Delb├Ęs, who specializes in reproductive toxicology, conducted a pilot study in collaboration with oncologists and fertility specialists from the McGill University Health Centre (MUHC) on a cohort of 13 patients, all survivors of pediatric leukemia and lymphoma.

'Combo' nanoplatforms for chemotherapy
In a paper to be published in the forthcoming issue in NANO, researchers from Harbin Institute of Technology, China have systematically discussed the recent progresses, current challenges and future perspectives of smart graphene-based nanoplatforms for synergistic tumor therapy and bio-imaging.

Nanotechnology improves chemotherapy delivery
Michigan State University scientists have invented a new way to monitor chemotherapy concentrations, which is more effective in keeping patients' treatments within the crucial therapeutic window.

Novel anti-cancer nanomedicine for efficient chemotherapy
Researchers have developed a new anti-cancer nanomedicine for targeted cancer chemotherapy.

Ending needless chemotherapy for breast cancer
A diagnostic test developed at The University of Queensland might soon determine if a breast cancer patient requires chemotherapy or would receive no benefit from this gruelling treatment.

A homing beacon for chemotherapy drugs
Killing tumor cells while sparing their normal counterparts is a central challenge of cancer chemotherapy.

Read More: Chemotherapy News and Chemotherapy Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to