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Treatment shifts away from chemotherapy for multiple myeloma

pharmafile | December 10, 2014 | News story | Research and Development, Sales and Marketing Kyprolis, carfilzomib, chemotherapy, myeloma, onyx pharmaceuticals 

Results from a Phase III study of a new multiple myeloma offering have found promising results for a treatment that could create a ‘new standard of care’ for multiple myeloma. 

Figures from Cancer Research UK show there are 39,000 new cases of multiple myeloma in Europe every year. Several firms are developing and testing new treatments for the disease and these are often designed to be used in combination with existing chemotherapy drugs, and for patients who have already been treated but whose cancer has returned. 

Researchers and industry experts believe the standard of care for multiple myeloma may be shifting away from chemotherapy, and towards combinations of steroids and drugs that specifically target the immune system. 

A study found that adding Kyprolis (carfilzomib) by Onyx Pharmaceuticals, a second-generation proteasome inhibitor, to standard therapy, might improve treatment responses in patients with relapsed or treatment-resistant multiple myeloma.

Researchers enrolled 792 patients from 20 countries in a Phase III trial, randomly allocating them to receive the standard combination of lenalidomide and dexamethasone or the combination along with Kyprolis.

Their interim analysis found the group treated with Kyprolis had a longer duration of response without disease progression (26.3 months) compared with the group who had standard therapy (17.6 months). The difference in overall response rates in the two treatment groups was also significant, at 87.4% in the Kyprolis group compared to 66.9% in the standard therapy group.

There were similar findings in terms of toxicity in the two groups. In the Kyprolis group 15.2% of people discontinued treatment due to serious adverse events compared with 17.4% of patients in the standard treatment group. Patients in the Kyprolis group also had higher quality of life scores than those receiving standard therapy. 

Lead study author Keith Stewart from the Mayo Clinic in Scottsdale, Arizona, says: “By adding carfilzomib to the gold standard in multiple myeloma therapy, we are observing an unprecedented duration of remission without additional toxicity, a promising outcome in relapsed and heavily pre-treated patients.” 

“We hope that the results of this trial will lead to approval of this treatment combination in patients with relapsed multiple myeloma worldwide.”

Dr Brian Durie, chair of the board of the International Myeloma Foundation, says: “The ASPIRE showed adding carfilzomib gives substantially better progression-free survival and a really important improvement by using three drugs in a novel combination, which looks to be better than using two drugs. 

“These can generate a new standard of care, by fine-tuning what we know about existing multiple myeloma treatments, and adding new treatments to that.” 

Lilian Anekwe

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