In a nutshell
This study aimed to compare the long-term effects of thalidomide (Immunoprin) to those of classic anti-cancer drugs in patients with recently diagnosed multiple myeloma. Thalidomide appeared effective but many patients experienced side-effects that affected treatment.
Some background
Vincristine (Oncovin), doxorubicin (Adriamycin) and dexamethasone (Dexasone) are commonly used in combination to treat multiple myeloma (MM). Vincristine is used to stop the growth of tumor cells in many cancer types. Doxorubicin is a chemotherapy drug which stops or slows the growth of cancer cells. Dexamethasone is a type of steroid, used in many forms of cancer. Thalidomide is an anti-cancer drug which is also used to treat MM. Melphalan (Alkeran) is also an anti-cancer drug. Stem-cell transplant is also used to treat MM. This involves the transfer of stem-cells to the patient. Common side effects associated with cancer treatments include tiredness and nerve pain.
It is important to investigate the long-term effects of anti-cancer treatments.
Methods & findings
This study included 556 patients with recently diagnosed MM. Patients underwent stem cell transplant with melphalan treatment. Those who responded received further treatment. Two hundred and sixty-eight patients received vincristine, dexametheasone and doxorubicin over 28 days. Two hundred and sixty-eight patients received dexametheasone, doxorubicin and thalidomide over 28 days. Patients underwent therapy until the cancer got worse, or came back after being cured.
Sixty-five percent of patients treated with thalidomide stopped therapy due to side-effects. Seventy-five percent of these experienced neuropathy. Six percent experienced skin rashes/inflammation. Three percent of patients experienced fatigue. Twenty-three patients treated with thalidomide and 24 treated without thalidomide, developed a second form of cancer.
The bottom line
This study suggested that thalidomide could be used for the treatment of MM. However, it is necessary to monitor patients for side-effects.
The fine print
This study only included patients from Belgian and Dutch hospitals. Therefore the results may not apply to patients from elsewhere.
What’s next?
If you have questions about the treatment of MM, please ask your doctor.
Published By :
The Lancet. Haematology
Date :
Oct 01, 2018
