Nav: Home

Additions to standard multiple myeloma therapy do not appear to yield additional benefit

December 06, 2016

(San Diego, December 6, 2016) - Trial results being presented today during the 58th American Society of Hematology (ASH) Annual Meeting and Exposition in San Diego suggest two therapies that are often added to standard therapy in patients with multiple myeloma do not improve rates of progression-free survival compared with the current standard course of treatment alone. The study is the largest randomized controlled trial of post-transplant therapy for multiple myeloma ever conducted in the United States.

Multiple myeloma, a cancer of the plasma cells - cells that exist in the bone marrow that help fight infection - that is diagnosed in about 30,000 people per year in the United States. For physically fit individuals below age 70, standard care consists of three components: 1) A course of initial therapy with combinations of proteasome inhibitors, thalidomide analogues, corticosteroids and alkylating agents, then high doses of the chemotherapy drug melphalan to kill cancer cells, 2) transplantation of the patient's own hematopoietic stem cells (autoHCT) to help rebuild the immune system, and 3) ongoing treatment with the chemotherapy drug lenalidomide to prevent cancer from returning. Over the past decade, many doctors have added to this regimen either by incorporating an additional intensive three-drug course of chemotherapy after autoHCT (including the drugs dexamethasone and bortezomib in addition to lenalidomide), or by adding a second round of autoHCT.

"These results are very important because they answer a question that has been ongoing and has not been compared head-to-head: 'Does the addition of these interventions result in a true advantage for these patients?'" said lead study author Edward A. Stadtmauer, MD, of the Abramson Cancer Center, University of Pennsylvania in Philadelphia. "The conclusion of this study, so far, is that the other interventions are not superior to initial melphalan therapy followed by a single autoHCT followed by lenalidomide maintenance."

The researchers, participating in a national collaborative effort of 54 centers, enrolled 758 patients and randomly assigned them to receive either standard care, standard care plus additional chemotherapy, or standard care plus a second round of autoHCT. With almost all patients nearing the end of follow-up, the study's Data and Safety Monitoring Board released the current results. The results showed no difference among the three groups in terms of the study's primary endpoint--38-month survival without disease progression, as indicated by intent-to-treat--with progression-free survival observed in 52 percent, 57 percent, and 56 percent of patients in each of the three treatment arms, respectively.

The final analysis and the analysis of secondary outcomes including quality of life indicators, the degree of disease response, and evidence of toxicity will be available after all patients have completed 38 months of follow-up.

"Despite remarkable advances in the therapy and outlook for patients with multiple myeloma over the last decade, ultimately many patients will have their disease progress. So, there's always room for improvement," said Dr. Stadtmauer. "New therapies and interventions need to be actively investigated to see how much they further benefit the early treatment of patients with myeloma; I believe that the results of this study suggest it would be reasonable to compare any new treatments to the standard therapy of melphalan followed by a single autoHCT followed by lenalidomide maintenance."

The researchers will track patients in a follow-up study to assess long-term trends and outcomes.
-end-
The study was funded by the Blood and Marrow Transplant Clinical Trials Network which is supported by the National Heart, Lung and Blood Institute and National Cancer Institute of the United States National Institutes of Health under Grant No. U01-HL069294. Additional funding was provided by Celgene and Takeda Oncology, makers of lenalidomide and bortezomib, respectively. Patients were enrolled by centers participating in the BMT CTN as well as through the NCI funded National Clinical Trials Network (NCTN) including ECOG-ACRIN Cancer Research Group, SWOG and the Alliance for Clinical Trials in Oncology.

Edward A. Stadtmauer, MD, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pa. will present this study, titled "Comparison of Autologous Hematopoietic Cell Transplant (autoHCT), Bortezomib, Lenalidomide (Len) and Dexamethasone (RVD) Consolidation with Len Maintenance (ACM), Tandem AutoHCT with Len Maintenance (TAM) and AutoHCT with Len Maintenance (AM) for up-Front Treatment of Patients with Multiple Myeloma (MM): Primary Results from the Randomized Phase III Trial of the Blood and Marrow Transplant Clinical Trials Network (BMT CTN 0702 - StaMINA Trial)," (LBA-1) during the late-breaking abstracts session on Tuesday, December 6 at 7:30 a.m. PST in Hall AB.

For the complete annual meeting program and abstracts, visit http://www.hematology.org/annual-meeting. Follow @ASH_hematology and #ASH16 on Twitter and like ASH on Facebook for the most up-to-date information about the 2016 ASH Annual Meeting.The American Society of Hematology (ASH) (http://www.hematology.org) is the world's largest professional society of hematologists dedicated to furthering the understanding, diagnosis, treatment, and prevention of disorders affecting the blood. For more than 50 years, the Society has led the development of hematology as a discipline by promoting research, patient care, education, training, and advocacy in hematology. The official journal of ASH is Blood (http://www.bloodjournal.org), the most cited peer-reviewed publication in the field, as well as the newly launched, online, open-access journal, Blood Advances (http://www.bloodadvances.org).

American Society of Hematology

Related Cancer Articles:

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.
Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.
Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.
Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.
More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.
New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.
American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.
Oncotarget: Cancer pioneer employs physics to approach cancer in last research article
In the cover article of Tuesday's issue of Oncotarget, James Frost, MD, PhD, Kenneth Pienta, MD, and the late Donald Coffey, Ph.D., use a theory of physical and biophysical symmetry to derive a new conceptualization of cancer.
Health indicators for newborns of breast cancer survivors may vary by cancer type
In a study published in the International Journal of Cancer, researchers from the UNC Lineberger Comprehensive Cancer Center analyzed health indicators for children born to young breast cancer survivors in North Carolina.
Few women with history of breast cancer and ovarian cancer take a recommended genetic test
More than 80 percent of women living with a history of breast or ovarian cancer at high-risk of having a gene mutation have never taken the test that can detect it.
More Cancer News and Cancer Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Climate Mindset
In the past few months, human beings have come together to fight a global threat. This hour, TED speakers explore how our response can be the catalyst to fight another global crisis: climate change. Guests include political strategist Tom Rivett-Carnac, diplomat Christiana Figueres, climate justice activist Xiye Bastida, and writer, illustrator, and artist Oliver Jeffers.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Speedy Beet
There are few musical moments more well-worn than the first four notes of Beethoven's Fifth Symphony. But in this short, we find out that Beethoven might have made a last-ditch effort to keep his music from ever feeling familiar, to keep pushing his listeners to a kind of psychological limit. Big thanks to our Brooklyn Philharmonic musicians: Deborah Buck and Suzy Perelman on violin, Arash Amini on cello, and Ah Ling Neu on viola. And check out The First Four Notes, Matthew Guerrieri's book on Beethoven's Fifth. Support Radiolab today at Radiolab.org/donate.