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Bortezomib alone or in combination with other therapies shows promise in a wide range of patients with multiple myeloma including those with renal damage

Bortezomib alone or in combination with other therapies shows promise in a wide range of patients with multiple myeloma, including patients with renal damage and patients with chromosome 13 deletions, according to two presentations at the annual meeting of the American Society of Hematology.

The first study presented at the meeting was a multi-center, retrospective review of safety and efficacy in patients with relapsed multiple myeloma who had renal failure requiring hemodialysis, an analysis conducted by Asher Alban Chanan-Khan, MD, of Roswell Park Cancer Institute in Buffalo, New York.

Analysis was based on data for 24 evaluable patients. The overall response rate of 78 percent included both single-agent treatment and various bortezomib-based combination regimens; 33 percent of patients had either a complete or near-complete response (median, 7.5 cycles). Of the 24 patients, 3 (12.5 percent) had a complete response and were able to discontinue dialysis.

The safety profile was favorable. With full-dose therapy, the rate of serious adverse events was low and was not increased over rates seen in patients with normal renal function.

"Patients with relapsed, refractory multiple myeloma often present with renal failure which can greatly impact their ability to tolerate treatment," said Chanan-Khan. "These results suggest that bortezomib may enable us to overcome this challenge and offer a much needed treatment option for these patients."

The second presentation on bortezomib in 51 patients with poor prognosis was a retrospective analysis of patients with chromosomal abnormalities (primarily chromosome 13 deletions) who were treated at the Medical University of Vienna, Austria; Johannes Drach, MD, was lead investigator.

Outcomes were response rate, time to treatment failure, and overall survival. Patients had received a median of three prior therapies.

Overall response rates, including complete and near-complete responses, and duration of response were independent of chromosome 13 status. In patients with the chromosome 13 deletion, overall response rate was 50 percent, with 23 percent achieving a complete response and a 10.4-month duration of response. Median overall survival was 15 months, and it was also independent of chromosome 13 status.

Response rate and overall survival were also independent of other poor prognostic factors including 14q abnormality and Beta-2 microglobulin level.

"The important observation is that with bortezomib treatment, we do not see a difference in response rate or duration of response for patients with and without a 13q deletion," said Drach. "This is different from the experience with chemotherapy and even transplantation."

 

 

 


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