By Karla Harby
NEW YORK, Jul 19 (Reuters Health) - In the largest series of patients with refractory multiple myeloma treated with thalidomide that has been reported to date, 14% achieved a complete response or nearly complete response, with almost 50% of patients still alive after 2 years, according to Dr. Bart Barlogie of the University of Arkansas for Medical Sciences, Little Rock.
"This is most unusual in a setting of post-high-dose chemotherapy relapse and refractoriness," Dr. Barlogie said. He described his findings here at a session at the 13th International Symposium on Molecular Biology of Hematopoiesis and Treatment of Leukemia and Cancer.
Dr. Barlogie and colleagues have now treated more than 300 multiple myeloma patients with thalidomide. Although notorious for having induced severe birth defects decades ago, when taken to prevent morning sickness during pregnancy, a number of researchers have been exploring thalidomide's usefulness for treating a variety of other conditions, including cancers.
Patients in this study on thalidomide experienced a variety of toxicities, including constipation, fatigue, neuropathy and deep venous thrombosis. Dose-escalation studies with doses ranging from 200 to 800 mg have shown that 90% of patients can tolerate a dose of 400 mg, Dr. Barlogie said.
Because single-agent thalidomide has shown effectiveness even in patients who have already been heavily treated, Dr. Barlogie is now evaluating thalidomide combined with standard chemotherapy in newly diagnosed multiple myeloma. Early results appear encouraging, he said, with a greater than 75% reduction in tumor burden in about half of the patients.
"Thalidomide is ideal to be combined with chemotherapy because of its lack of myelosuppressive toxicity," he noted.
As reported by Reuters Health, Dr. Barlogie and a multicenter team presented data on 84 patients in the November 18, 1999 issue of The New England Journal of Medicine.