Thalidomide Treatment for Multiple Myeloma

[Angel]

Doctors are calling the addition of thalidomide to the standard treatment for multiple myeloma a "historic moment in myeloma therapy."

A new study from the University of Torino, Italy, shows giving the drug to elderly patients can help them live longer without recurrence.

"After 50 years of unsuccessful attempts to find new and more effective treatment approaches suitable for most patients with myeloma, our results lend support to the use of thalidomide in the initial treatment of elderly patients with multiple myeloma," says Dr. Antonio Palumbo, of Univerisity of Torino in Italy.

Researchers evaluated 255 newly diagnosed patients who were mainly ages 65 and older and a few younger patients who were not eligible for high-dose therapy and stem-cell rescue (HDT). They found patients treated with melphalan, prednisone, and thalidomide (MPT) responder better and lived event-free longer than those treated with melphalan and prednisone (MP) alone. MP is the standard therapy for older patients.

The results may not seem like enough evidence to change clinical practice because the study did not show an overall survival advantage. But because a similar study in France showed significantly better progression-free and overall survival with MPT, researchers say the treatment should be considered as standard therapy for older patients and those ineligible for HDT.

But the study authors warn the benefits of thalidomide must be weighed against the risks -- increased rates of thrombosis, neurological toxic effects, and infection.