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Melphalan hydrochloride (trade name Alkeran) is a chemotherapy drug belonging to the class of nitrogen mustard alkylating agents. It is used primarily to treat multiple myeloma and ovarian cancer, and occasionally malignant melanoma. Otherwise known as L-Phenylalanine Mustard, or L-PAM, melphalan is a phenylalanine derivative of mechlorethamine. The agent was first investigated as a possible drug for use in melanoma. It did not work, but was found to be of use in myeloma. [...] Headline, News »
The results of a recent study suggest that consecutive low-dose melphalan and high-dose melphalan treatment combined with autologous stem cell transplants is an effective treatment for multiple myeloma patients with manageable side effects.
“The low-dose melphalan step led to complete response and very good partial response rates similar to those of combinations containing Velcade and steroids at a fraction of the cost,” wrote Dr. Nicolas Novitzky, the …
Tags: Dexamethasone Melphalan Multiple Myeloma Research Summary Stem Cell Transplant
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Advances in the development of multiple myeloma drugs have had a profound impact on the way the disease is treated. Given the efficacy and relative safety of these novel agents, studies are being conducted to determine whether they may be as effective, or possibly even more effective, than an autologous stem cell transplant (ASCT). Two such studies were presented June 6 at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago.
Results from the two studies suggest that ASCT (in which a patient’s own stem cells are transplanted after chemotherapy) may not be necessary if replaced with…
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A recent study conducted in Scandinavia shows that the combination treatment of melphalan (Alkeran), prednisone and thalidomide (Thalomid), referred to as MPT, has significant anti-myeloma effects when compared to melphalan and prednisone treatment, referred to as MP, in elderly patients. However, MPT treatment did not increase progression-free and overall survival or improve quality of life compared to MP treatment.
Studies examining the effect of adding thalidomide to MP treatment have previously been conducted in several European countries. All studies found that the addition of thalidomide increased anti-myeloma effects. However, the results varied significantly for progression-free and overall…
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The combination therapy of Velcade (bortezomib), melphalan (Alkeran), and prednisone, commonly referred to as VMP, extends overall survival in newly diagnosed multiple myeloma patients, compared to melphalan-prednisone (MP) therapy, even after prolonged follow-up and extensive subsequent therapy. Researchers also found that VMP did not increase resistance to subsequent therapy.
The Phase 3 clinical trial, known as VISTA, had shown that VMP therapy improved outcomes in newly diagnosed multiple myeloma patients compared to MP therapy. In particular, patients on VMP showed better response and longer overall survival than patients on MP.
However, the follow-up time associated with the…
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The combination regimen of Revlimid (lenalidomide), melphalan (Alkeran), prednisone, and thalidomide (Thalomid), abbreviated RMPT, is an active and safe therapy for multiple myeloma patients who have relapsed or who are resistant (refractory) to previous myeloma treatment. The findings were published recently in the journal Leukemia.
Although melphalan-prednisone (MP) combination has been a standard therapy in multiple myeloma for the last thirty years, the introduction of novel agents, such as Revlimid, thalidomide and Velcade, has significantly improved response rates and extended remission in patients with refractory and relapsed myeloma. Revlimid and thalidomide are from the same…
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A recent study suggests that the addition of defibrotide to the combination regimen of melphalan (Alkeran), prednisone, and thalidomide (Thalomid) may result in fewer side effects in multiple myeloma patients. The Phase 1 clinical trial results were recently published in the journal Haematologica.
With the development of multiple myeloma therapies, the traditional melphalan-prednisone (MP) treatment regimen has been combined with substances such as Velcade (bortezomib) and thalidomide for more effective results. In particular, clinical trials have shown that these new combination treatments produce greater responses in patients than the traditional MP treatment regimen.
However, the…
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The results of a recent Phase 3 clinical trial indicate that treatment with high-dose melphalan (Alkeran) prior to a stem cell transplant results in a longer period of remission for myeloma patients than treatment with reduced-intensity melphalan. The differences in remission duration were larger for patients younger than 60 years old.
Based on the significant difference in progression-free survival between the two treatment groups, the researchers concluded that high-dose (200 mg/m2) melphalan is more effective in preparing younger, medically fit multiple myeloma patients for stem cell transplants. However, reduced-intensity (100 mg/m2) melphalan may be safer in patients with other…
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Results from a new study indicate that, in elderly multiple myeloma patients, a combination drug regimen of Velcade (bortezomib), melphalan (Alkeran), prednisone, and thalidomide (Thalomid) (VMPT), followed by a maintenance regimen of Velcade and thalidomide, is superior to the current standard treatment of Velcade, melphalan, and prednisone (VMP) without a maintenance regimen. The authors of the study will be presenting the results of the Phase 3 clinical trial at the upcoming American Society of Hematology (ASH) Annual Meeting and Exposition.
In the study, scientists randomly assigned 511 myeloma patients older than 65 years to receive either…
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On September 2, Millennium: The Takeda Oncology Company reported that the company’s supplemental new drug application (sNDA) has been accepted for review by the U.S. Food and Drug Administration. The acceptance is based on the long-term overall survival data from the VISTA Phase 3 clinical trial that examined the use of Velcade (bortezomib) for treatment of previously-untreated multiple myeloma.
The VISTA trial compared a drug regimen of Velcade, melphalan (Alkeran), and prednisone with a drug regimen of melphalan and prednisone without Velcade in patients with previously untreated myeloma. The multicenter, international trial enrolled 682 patients with…