Skip to content
My WebMD Sign In, Sign Up

Cancer Health Center

Font Size

Newer Drug Helps Older Myeloma Patients

Treatment may extend survival for patients over 65, researchers say

continued...

It has side effects, such as infections, and some patients using it have developed second cancers, such as leukemia or lymphoma. Plus, maintenance therapy with the drug -- which costs about $160,000 a year in the United States -- hasn't yet been shown to extend patients' lives.

"But it does prolong the period of remission," Avigan said. "And for many people, that's enough."

However, many patients with myeloma aren't eligible for a stem cell transplant, including those older than 65 or 70.

"At least 50 percent of patients with newly diagnosed myeloma are considered transplant-ineligible," said Dr. Thierry Facon, the senior researcher on the second study.

In Europe, patients who can't have a transplant usually receive a particular triple-drug combination, said Facon, a hematologist at University Hospital of Lille in France.

To see whether lenalidomide plus an anti-inflammatory drug -- dexamethasone -- might work better, they recruited more than 1,600 transplant-ineligible myeloma patients. One-third were randomly assigned to 72 weeks of a standard drug combo (melphalan, prednisone and thalidomide); another third took lenalidomide/dexamethasone over 72 weeks; and the final third kept taking the drug duo until their cancer progressed.

Overall, the study found, patients fared best with continuous lenalidomide. They typically went more than 25 months with no cancer progression versus around 21 months with the other two treatments.

Their longer-term outlook was also brighter. At four years, 59 percent were still alive, compared with 56 percent of patients who received lenalidomide for only 72 weeks, and 51 percent of those given the standard drug regimen.

Facon said that lenalidomide is not formally approved as a first-choice treatment for patients who can't have a transplant. But he said U.S. doctors can, and do, use it that way. The findings will have a greater impact in other countries, he said.

Avigan agreed that "it's standard" for U.S. patients who can't have a transplant to take lenalidomide. But doctors "go back-and-forth" on whether continuous therapy or a finite number of treatments is better, he said.

These new findings suggest that continuous therapy may be a bit more effective, Avigan said. "But the differences aren't immense," he added.

Patients on ongoing therapy had more infections than those on shorter-term lenalidomide, Avigan said, though that was the only extra risk seen.

Facon said he's not yet convinced that continuous lenalidomide is actually better than a finite course, and more study is needed.

Both new studies received funds from Revlimid maker Celgene.

1|2

Today on WebMD

Building a Support System
Blog
cancer fighting foods
SLIDESHOW
 
precancerous lesions slideshow
SLIDESHOW
quit smoking tips
SLIDESHOW
 
Jennifer Goodman Linn self-portrait
Blog
what is your cancer risk
HEALTH CHECK
 
colorectal cancer treatment advances
Video
breast cancer overview slideshow
SLIDESHOW
 
prostate cancer overview
SLIDESHOW
lung cancer overview slideshow
SLIDESHOW
 
ovarian cancer overview slideshow
SLIDESHOW
Actor Michael Douglas
Article