Three-drug regimen provides rapid, durable responses for multiple myeloma

A three-drug treatment for the blood cancer multiple myeloma provided rapid, deep and potentially durable responses, researchers report today online in Blood, the Journal of the American Society of Hematology, and yesterday, Sunday, June 3, 2012, at the American Society of Clinical Oncology's Annual Meeting in Chicago, IL, USA.

The researchers, led by Andrzej J. Jakubowiak, M.D., Ph.D., professor of medicine and director of the multiple myeloma program at the University of Chicago Medical Center, found that combining carfilzomib, a next generation proteasome inhibitor, with two standard drugs - lenalidomide and low-dose dexamethasone compared favorably to other frontline regimens.

The longer patients stayed on the therapy, the better their response. After at least eight 28-day cycles of treatment, 61 percent of the 36 patients who remained on the therapy had a stringent complete response, defined as no detectable tumor cells or myeloma protein in the blood or bone marrow; 78 percent had at least a near complete response. More than 90 percent of patients had no progression of their disease at two years.

"These rapid and durable response rates are higher than those achieved by the best established regimens for newly diagnosed multiple myeloma," said Jakubowiak. "We have observed excellent efficacy, the best reported to date, and very good tolerability, including limited peripheral neuropathy that has been problematic with other drug combinations."

The research team enrolled 53 patients in the trial at four centers. Patients, aged 35 to 81, all had newly diagnosed multiple myeloma. Every patient received all three drugs and the carfilzomib dose levels were increased twice for new patients as the study progressed. Most patients responded rapidly to the combination and continued to improve.

"Newly diagnosed patients with myeloma are most sensitive to treatment," Jakubowiak said. "A rapid and sustained response to the initial phase of treatment, as in the case of this study, can typically project longer remission, and, possibly, longer overall survival."