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).