Mayo Clinic researchers announce promising next generation treatments for multip...( en of thalidomide and dexamethasone. Th...),Health

en of thalidomide and dexamethasone. The other half were assigned to take dexamethasone alone as the first treatment for their disease. After four months, a significantly greater proportion of patients -- 63 percent -- responded to the combination of thalidomide plus dexamethasone compared to the 41 percent whose cancer responded to dexamethasone alone.

While these results are encouraging, the side effects of thalidomide plus dexamethasone were significantly higher compared to dexamethasone alone, particularly blood clots. Blood clots occurred in about 18 percent of patients who took the combination drug regimen, compared to only 3 percent of patients who took dexamethasone alone. The researchers stated that the risks and benefits need to be weighed for each patient in determining what regimen to use for initial therapy. Researchers also recommend patients receive blood thinners to minimize the risk of blood clots when using thalidomide plus dexamethasone.

"Based on this study, thalidomide plus dexamethasone has probably become an appropriate replacement for intravenous vincristine, adriamycin, dexamethasone (VAD) chemotherapy, except for patients with less aggressive disease for whom dexamethasone alone may be adequate," says Dr. Rajkumar.

In the second study, Mayo Clinic researchers showed that using a new "cousin" of thalidomide may be more effective and safer in treating newly diagnosed myeloma. This analog of thalidomide is called CC-5013 (lenalidomide) and is not currently commercially available.

Mayo Clinic began a small, tightly-controlled study in 30 patients who were newly diagnosed with multiple myeloma. Patients were treated with CC-5013 plus dexamethasone. The results of this study were announced for the first time at the San Diego meeting. Out of 30 patients treated, 83 percent responded to this therapy, and -- in dramatic contrast to the thalidomide experience -- no blood clots have been observed so far.

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Contact: Cathy Stroebel
newsbureau@mayo.edu
507-284-5005
Mayo Clinic
6-Dec-2004

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