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Page: << Prev | 1 | 2 | 3 | Next >> Thalidomide has a checkered past, however, most notably as the cause of devastating birth defects.
Lenalidomide (brand name Revlimid) is a newly developed chemical cousin of thalidomide, said Streicher, a senior investigator at the NCI.
"It doesn't seem to cause the same kind of birth defects, it doesn't have the sedative quality, and it is probably more potent and active than thalidomide in myeloma," he said.
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Doctors have also long used dexamethasone (brand named Decadron) to fight myeloma, because the drug appears to induce cancer cell death.
But dexamethasone has its drawbacks, too -- most notably an increase in the risk for deep vein thrombosis (DVT) and pulmonary embolisms, potentially life-threatening blood clots.
The new trial attempted to see if a lower dose of dexamethasone would work just as well as the higher dose, when combined with the same dose of lenalidomide.
In the trial, Streicher and his colleagues compared survival and toxicity levels in 445 patients with newly diagnosed multiple myeloma. None of the patients had been on any other form of chemotherapy prior to the trial, which was scheduled to run for two years. Patients were randomly chosen to receive either low- or high-dose dexamethasone treatment plus lenalidomide.
The one-year results have been a pleasant surprise, Streicher said.
"The response rates in terms of survival were very high in both arms, and it was even higher with a lower dose of dexamethasone," he said. "It was higher than anything that we had hoped for."
He said it's unclear why lowering the dose of dexamethasone improved survival, although reduced toxicities probably played a big role. Rates for most side effects -- especially dangerous clotting -- associated with the steroid fell as the dose got lower, Streicher noted.
In fact, "the results have been so positive that (the study's review board) stopped the trial early so that they would not deny the patients in this trial -- and patients in general -- to be treated in this fashion," Lichtenfeld said. "That's usually a very, very positive indicator of a successful trial."
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