Email Newsletter, Volume 1, Issue 2

Drug combination treats multiple myeloma with fewer side effects

Joseph R. Mikhael, M.D.

A four-drug combination of chemotherapy boasted strong results as a highly effective treatment for patients newly diagnosed with the blood cancer multiple myeloma, according to results from a Mayo Clinic-led study. In the phase II trial, the multidrug regimen, called CYCLONE (cyclophosphamide, carfilzomib, thalidomide and dexamethasone), worked quickly and effectively and was well-tolerated by study participants.

"Within only four cycles of treatment, 96 percent of patients responded favorably to the therapy," said lead researcher Joseph R. Mikhael, M.D., a hematologist at Mayo Clinic Cancer Center in Arizona. "Furthermore, 75 percent experienced a very good partial remission, meaning there was a 90 percent reduction of their tumor. A third of the patients experienced a complete remission, where the tumor was no longer detectable."

Dr. Mikhael presented the study at the 2012 American Society of Clinical Oncology Annual Meeting in Chicago.

The study participants also experienced fewer side effects compared to currently available therapies, Dr. Mikhael said. Side effects associated with multiple myeloma treatment typically involve the nerves, causing numbness, tingling and pain. The American Cancer Society estimates that 21,700 new cases of multiple myeloma will be diagnosed this year. Multiple myeloma is an incurable cancer of the plasma cells, found within the bone marrow. Abnormal plasma cells (myeloma cells) multiply in the bone marrow, resulting in fewer healthy blood cells. These abnormal plasma cells also produce an abnormal protein known as a monoclonal protein (M protein) that can cause bone fractures and damage the organs, especially the kidneys. Patients are typically treated with chemotherapy, followed by a stem cell transplant.

The next step in the CYCLONE trial is to increase the dosage of carfilzomib to attempt an even deeper response with limited side effects, Dr. Mikhael said.

The study was funded by Onyx Pharmaceuticals (the maker of carfilzomib) and included researchers from the Mayo Clinic Cancer Center in Rochester, Minn.; Fred Hutchinson Cancer Research Center in Seattle; and the Medical University of South Carolina in Charleston, S.C. For information about cancer clinical trials at Mayo Clinic, call 507-538-7623.

Watch a video of Dr. Mikhael discussing this study.