The combination of two pills -- thalidomide and dexamethasone -- may be an effective alternative to the intravenous chemotherapy commonly prescribed to patients with multiple myeloma, according to a large collaborative study conducted by the Eastern Cooperative Oncology Group and led by a Mayo Clinic investigator.
More than 15,000 Americans are diagnosed annually with multiple myeloma, an incurable cancer of the bone marrow. Mayo Clinic researchers announced their findings today during a press conference at the annual meeting of the American Society of Hematology in San Diego. They also announced a second new finding: results of a smaller study using a less toxic and more effective “cousin” to thalidomide that they believe will soon assume a leading role in the treatment of myeloma.
The fact that thalidomide -- an old drug with a tragic past of causing birth defects -- can slow the progression of recurrent multiple myeloma is not new. But the studies discussed today show that thalidomide and its analog can be effectively combined with dexamethasone as the initial treatment for patients newly diagnosed with multiple myeloma.
“These oral regimens are as effective as the standard intravenous chemotherapy treatments commonly used as initial therapy for myeloma,” says Vincent Rajkumar, M.D., the Mayo Clinic hematologist/oncologist who led the studies. “However, the treatment of multiple myeloma is like a marathon. In addition to improving the initial therapy to get the disease under control, we need to improve other phases of treatment which include stem cell transplantation, maintenance therapy and treatment of relapse. At Mayo, we are committed to improving all phases of treatment, and at the same time, we are striving to develop a cure.”
Major findings of the two studies In the first study, 207 patients newly diagnosed with myeloma were treated. Half were randomly assigned to the combination regimen of thalidomide and dexamethasone. The other half were assigned to take dexamethasone alone as the first treatment for their disease. After four months, a significantly greater proportion of patients -- 63 percent -- responded to the combination of thalidomide plus dexamethasone compared to the 41 percent whose cancer responded to dexamethasone alone.