Enough about me! Here’s an excerpt I saved from earlier this week on OncLive.com, featuring an interview with Dana-Farber’s Dr. Ken Anderson:
Overcoming Genetic Transformation in Multiple Myeloma
Bonnie Gillis – OriginallyPublished Online: Tuesday, November 6, 2012
The goal in treating newly diagnosed multiple myeloma is to achieve deep remission and prevent relapse, Kenneth C. Anderson, MD, told attendees at the NCCN 7th Annual Congress on Hematologic Malignancies. This is best achieved by targeted combination therapy very early in the course of disease, he added.
“Why am I so passionate about this? Multiple myeloma is a complex disease. The average number of mutations at diagnosis is 58. We have new data showing that at relapse, new mutations arise, copy numbers change, and the translocations change. Although a number of studies have identified genes that are expressed in myeloma, there is presently no universally applicable genetic profile signature that can predict outcome,” said Anderson, director of the Jerome Lipper Multiple Myeloma Center and LeBow Institute for Myeloma Therapeutics at the Dana- Farber Cancer Institute in Boston, Massachusetts.
Various regimens have been studied in newly diagnosed patients using different combinations of drugs, such as bortezomib (Velcade), lenalidomide (Revlimid), dexamethasone, and thalidomide.
“The studies have made a strong case for triplet combination therapy using a proteasome inhibitor and a thalidomide analog [immunomodulatory drug] both pre- and post-transplant. One of our favorite regimens [at Dana-Farber] is lenalidomide, bortezomib, and dexamethasone [RVD],” Anderson said.
A phase II study of RVD showed an overall response rate of 100%, a complete plus partial response rate of 57%, and better than a very good partial response rate of 74% (Blood. 2010;116[5]:679-686).
Another option is combining carfilzomib (Kyprolis), a newly approved proteasome inhibitor, with lenalidomide and dexamethasone (CRD). In a phase I/II study of CRD, 62% of patients achieved at least near-complete response and 42% achieved stringent complete response (Blood. 2012;120[9]:1801-1809).
“Results with CRD are exciting,” Anderson said.
Yet another three-drug regimen involves the oral proteasome inhibitor MLN9708, which is in clinical trials in combination with lenalidomide and dexamethasone. This all-oral regimen achieved 100% response in newly diagnosed patients and may turn out to be a viable option (J Clin Oncol. 2012;30[suppl; abstr 8033]).
“In transplant candidates, a three-drug regimen is most active. Data suggest that we can use new drugs to consolidate and increase response, prolong progression-free survival, reduce the risk of relapse, and extend survival,” Anderson commented…
Dr. Anderson goes on to discuss more about the potential of several drug combinations, along with advice about how to deal with the risk of secondary cancers.
CLICK HERE to read more.
Feel good and keep smiling! Pat
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