According to a new Czech study, posted earlier this month on Pub Med.gov, it doesn’t matter whether you pick thalidomide (Thalomid) or bortezomib (Velcade) for treatment following first relapse. Apparently both work about one half of the time.
Similar efficacy of thalidomide- and bortezomib-based regimens for first relapse of multiple myeloma.
Krejci M, Gregora E, Straub J, Minarik J, Scudla V, Adam Z, Krivanova A, Pour L, Zahradova L, Buchler T, Mayer J, Hajek R. Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Jihlavska 20, 625 00, Brno, Czech Republic
Many regimens containing novel drugs have been developed for multiple myeloma (MM). It is not yet clear whether some of the novel agents are better than others. In a retrospective study, we have analyzed the outcomes of patients with first relapse of MM treated with thalidomide-based (T) regimens (n = 105) or bortezomib-based (B) regimens (n = 106). Both T and B groups were comparable regarding basic clinical parameters and first-line therapies. Combination of thalidomide with an alkylating drug (A) and dexamethasone (D) was used in 91 cases, T with D in five cases, and T alone in nine cases. A combination of bortezomib with A and D was used in 58 patients, B with D or A in 40 patients, and B alone in eight patients. In the T group, ORR was 51%, median TTP from the start of treatment for relapse of 13.1 months, and median OS of 30.4 months. In the B group, ORR was 50% with median TTP of 16.7 months and median OS of 37.2 months. No significant differences in ORR (p = 0.774), TTP (p = 0.207), or OS (p = 0.889) were observed between the two groups. In conclusion, T- and B-based regimens appear to be equally effective in the treatment of first MM relapse.
I’m guessing the same can be said of lenalidomide (Revlimid) as well, wouldn’t you think”
The good news: This takes the pressure off a patient and their oncologist when trying to help choose which medication to use following relapse.
In the United States, another even more affective choice is available: A combination of Velcade, Revlimid and dexamethasone (VRD or RVD). That’s my chemo cocktail of choice now that my first relapse requires treatment.
Feel good and keep smiling! Pat