Articles tagged with: Bendamustine
Before I get started, I want to share good news about my ongoing myeloma therapy.
If you recall, after a recent relapse, my doctors and I had decided to try adding Revlimid (lenalidomide) to my doublet of Velcade (bortezomib) and dexamethasone (Decadron) one last time, hoping it might still work. Although it has only been two months, the combination does seem to be helping; my M-spike has dropped from 0.5 g/dL down to 0.4 g/dL, or 20 percent.
But enough about me!
I recently …
This Monday was the third day of the 2013 American Society of Hematology (ASH) annual meeting, which was held in New Orleans.
More than any other day of the conference, Monday was packed with important myeloma presentations, from 7:00 in the morning until almost 8:00 in the evening.
This ASH update will summarize the oral presentation sessions about treatment-related myeloma studies that were held Monday morning. An ASH update that was published on Wednesday focused on the sessions that were held Monday afternoon and evening.
Monday morning started with …
Results from a recent retrospective analysis conducted in Germany indicate that the combination of Velcade plus Treanda and prednisone is effective for relapsed and refractory multiple myeloma patients with kidney impairment.
Specifically, 67 percent of patients responded to the treatment, and kidney function improved in 86 percent of patients. The study investigators point out that the responses were rapid, with a median time to response of three weeks. With a median progression-free survival of 10 months, some patients experienced a long-term treatment-free interval.
Most of the severe side effects of …
Entinostat And Treanda Enhance Each Other’s Efficacy Against Myeloma Cells – Results from a recent preclinical study show that Treanda (bendamustine) and the investigational drug entinostat (SNDX-275) enhance each other’s efficacy against multiple myeloma cells. The two drugs, when given together, were more effective than expected based on the efficacy of either drug alone. Entinostat is an oral treatment that belongs to a family of anti-cancer drugs called HDAC inhibitors. Other HDAC inhibitors under investigation for multiple myeloma include Zolinza (vorinostat) and panobinostat. Entinostat is currently being studied in clinical trials for patients with leukemia and breast cancer. A Phase 1 study of Entinostat in myeloma patients and other blood cancer patients was recently completed, but the results have not been published yet. Treanda is approved in the United States as a treatment for chronic lymphocytic leukemia and certain lymphomas, and it is being investigated as a treatment for myeloma. It belongs to a class of drugs known as alkylating agents, which also includes melphalan (Alkeran) and cyclophosphamide (Cytoxan). These drugs damage the DNA of cancer cells, triggering their death. For more information, please refer to the study in Cancer Letters (abstract).
Low Levels Of Adiponectin May Be Associated With A Higher Risk Of Developing Myeloma – Findings from a prospective study show that low levels of the protein adiponectin may be associated with a higher risk of developing multiple myeloma. Adiponectin regulates glucose levels in the blood and is found at lower levels in people who have type-2 diabetes or who are obese. The investigators of the current study compared the levels of different proteins known as adipokines in 174 myeloma patients and 348 healthy individuals. They found that myeloma patients had lower levels of adiponectin than healthy individuals. Based on their findings, the researchers recommend further study of adiponectin as a possible therapeutic target for myeloma. For more information, please see the study in Cancer Epidemiology, Biomarkers, and Prevention (abstract).
Etoposide, Thiotepa, and Melphalan May Be More Effective Than Melphalan Alone – Results from a recent Israeli study show that treatment with etoposide (VP-16), thiotepa, and melphalan may be more effective than melphalan alone prior to stem cell transplantation. In particular, patients who received the three-drug combination had a longer time to progression (44 months versus 17 months) and longer overall survival (not yet reached after a median of 108 months follow-up versus 59 months) than those who received melphalan alone. However, the researchers said that based on the small number of patients included in the study, the three-drug combination appeared to be slightly more toxic than melphalan alone. The investigators still believe that the three-drug combination can be effective in certain myeloma patients receiving a stem cell transplant. Etoposide is a chemotherapy drug used as a treatment for lung and testicular cancer. Previous studies have shown that etoposide is highly effective in mobilizing stem cells. Thiotepa, like melphalan, is an alkylating agent that damages the DNA of cancer cells. For more information, please refer to the study in the journal Leukemia and Lymphoma (abstract).
Treanda May Enhance Response To Stem Cell Transplant In Myeloma Patients – Results from a Phase 1 clinical trial demonstrate the safety of adding Treanda (bendamustine) to melphalan (Alkeran) as high-dose therapy prior to stem cell transplantation. The researchers state that the side effects of Treanda-melphalan therapy were similar to those expected from melphalan alone. Of the 25 myeloma patients included in the study, the overall response rate was 79 percent, with 38 percent achieving a stringent complete response, 4 percent a complete response, 33 percent a very good partial response, and 4 percent a partial response. Treanda is approved in the United States as a treatment for chronic lymphocytic leukemia and certain lymphomas, and it is being investigated as a treatment for myeloma. It belongs to a class of drugs known as alkylating agents, which also includes melphalan and cyclophosphamide (Cytoxan). These drugs work by damaging the DNA of cancer cells, which in turn causes the cells to die. For more information, please see the study in the journal Biology of Blood and Marrow Transplantation (abstract).
Viracept May Overcome Velcade And Kyprolis Resistance In Multiple Myeloma – Findings from a recent preclinical study show that Viracept (nelfinavir) kills multiple myeloma cells, including those that are resistant to Velcade (bortezomib) and Kyprolis (carfilzomib). In addition, the researchers found that Viracept enhanced the effectiveness of Velcade and Kyprolis, particularly when administered to myeloma cells resistant to Velcade and Kyprolis. Viracept belongs to a class of drugs called protease inhibitors and was approved by the FDA to treat HIV in 1997. Viracept as well as Velcade and Kyprolis limit a cell’s ability to chop up and discard unwanted proteins. The accumulation of these unwanted proteins causes the cells to die. The researchers also investigated the anti-myeloma properties of eight other HIV protease inhibitors but found Viracept to be the most effective. The investigators therefore state that Viracept may be useful to overcome Velcade resistance and believe their results justify clinical study of Viracept in combination with Velcade or Kyprolis. For more information, please refer to the study in Blood Cancer Journal (full text).
Pseudo-Autologous Stem Cell Transplant May Be Feasible Following Relapse After Donor Transplant – Canadian myeloma experts report that a 54-year-old myeloma patient is doing well, remains drug-free, but has a low level of monoclonal protein one year after undergoing a “pseudo-autologous stem cell transplant.” The patient was diagnosed with stage 2 myeloma in May 1997 and was treated with a donor (allogeneic) stem cell transplant, but she relapsed after 12 years. Her physicians then had her undergo a pseudo-autologous stem cell transplant, hoping that she would achieve a similarly long response to the second transplant while avoiding complications associated with a second donor transplant. An autologous transplant typically involves collecting a patient’s own stem cells prior to high-dose chemotherapy, and then reinfusing the stem cells into the patient after the chemotherapy. In this case, the patient’s bone marrow also was repopulated with stem cells from the patient herself, but those stem cells were no longer her own original stem cells. Instead, they were stem cells descended from the donor stem cells she received during her allogeneic transplant in 1997. Thus, this procedure is known as a “pseudo-autologous” transplant. For more information, please see the case study in Bone Marrow Transplantation (subscription required).