Thalidomide Shows Promising Results in Patients With Multiple Myeloma

Research investigating the use of thalidomide in multiple myeloma report that 34% of patients treated with the drug experienced a reduction in tumor burden. Some patients experienced more than a 7,500-fold reduction in tumor growth, including three who approached a near complete response. In total, 89 patients participated in the trial, all of whom had exhausted conventional forms of therapy, including chemotherapy and bone marrow transplantation.

The data were presented at the 40th annual meeting of the American Society of Hematology by Seema Singhal, MD, of the Myeloma and Transplantation Research Center (MTRC) of the Arkansas Cancer Research Center (ACRC), part of the University of Arkansas for Medical Sciences, Little Rock.

All of the study participants had end-state refractory (nonresponsive) multiple myeloma, said Dr. Singhal, and each one had previously relapsed following treatments with other therapeutic modalities, including 75 who had received one bone marrow transplant and 56 who had had two prior transplants.

Findings Consistent With an Earlier Analysis

These recent findings are consistent with the results of an earlier analysis of 26 patients, which determined that over half of all patients with advanced disease developed either stable disease or improved with thalidomide therapy. Current clinical trials at MTRC, under the leadership of Bart Barlogie, MD, address the usefulness of adding thalidomide to primary induction therapy for newly diagnosed patients with myeloma, followed by tandem transplant and consolidation therapy.

Dr. Barlogie, the principal investigator of the thalidomide projects, added: “We are extremely pleased with the efficacy of thalidomide in these patients that had failed all other therapies.” He also noted that “thalidomide was also effective in patients with high grade myeloma, including those who had chromosome 13 deletion, which is usually refractory to high-dose chemotherapy and transplantation.” In addition, preliminary results indicate that the combination of thalidomide and chemotherapy appears to be effective in treating plasma cell leukemia and fulminant multiple myeloma.

Continuing Studies

Studies are continuing at the ACRC to evaluate the potential role of thalidomide in the treatment of multiple myeloma. Although researchers have not identified the mechanism by which thalidomide treats multiple myeloma, they suspect several actions are involved, including the possibility that thalidomide suppresses tumor necrosis factor-alpha production, and that it increases the body’s production of interleukin-10. Dr. Barlogie also believes that thalidomide works through antiangiogenesis, by preventing the growth of vessels that nourish the malignant cells, especially since myeloma is associated with increased blood vessel formation in the bone marrow.

Dr. Barlogie added that “additional studies are beginning at the MTRC, to evaluate the role of thalidomide in the treatment of acute leukemia, amyloidosis, and Waldenström’s macroglobulinemia, a cancer closely related to multiple myeloma.”