Dr. Ashraf Badros, a nationally recognized expert in multiple myeloma, offers perspective in an editorial in the May 10 issue of the New England Journal of Medicine accompanying three major clinical trials investigating lenalidomide maintenance therapy in multiple myeloma. The editorial discusses the significance of the studies in the treatment of multiple myeloma patients and the future of maintenance trials. All three clinical trials involved newly diagnosed multiple myeloma patients. In two of the three trials, the initial treatment was a stem cell transplant. All three trials reported significant improvement in time to progression in lenalidomide maintenance groups. Only one of the three trials, however, found that maintenance therapy improved the overall survival of patients.
In the editorial, Dr. Badros notes that additional data are needed before the drug can be accepted as a standard of care for myeloma patients. He says that there are important questions relevant to this therapy which need to be answered. He raises questions about overall survival outcomes, side effects, including the occurrence of second primary cancers, and the high cost of taking the drug over a long period of time as factors that require long-term follow-up studies. “The data on progression-free survival provide support for the use of lenalidomide maintenance therapy after careful assessment of the risks and benefits,” he says. “As myeloma evolves from an “incurable” cancer to a chronic disease, physicians are faced with the task of maximizing available treatments not only to improve survival but also to maintain their patients’ quality of life.”
Dr. Badros, a professor of medicine at the University of Maryland School of Medicine and a medical oncologist at the University of Maryland Greenebaum Cancer Center, has extensive clinical experience in the treatment of patients with multiple myeloma and is a member of the Hematologic Malignancies Program team at the cancer center. He was involved in the initial trials of lenalidomide and has conducted many clinical trials for treatment of relapsed and refractory multiple myeloma.
Each year, nearly 22,000 people in the United States will learn that they have multiple myeloma, which is a cancer of the plasma cells. Plasma cells are located in the bone marrow, the tissue in bones that makes blood. Plasma cells are part of the immune system which help protect the body from infections. In patients with multiple myeloma, abnormal plasma cells overproduce and collect in the bone marrow, slowly destroying the bone.
The University of Maryland Greenebaum Cancer Center is ranked in the nation’s top 25 cancer centers by U.S. News and World Report. The National Cancer Institute-designated center offers a multidisciplinary approach to treating all types of cancer and has an active cancer research program, including more than 200 clinical trials.
For more information about the University of Maryland Greenebaum Cancer Center, go to www.umgcc.org.