Multiple myeloma outcome after standard chemotherapy was comparable to high-dose chemoradiotherapy

06-20-2006

Multiple myeloma outcome after standard chemotherapy was comparable to high-dose chemoradiotherapy.

According to recent research from the United States, "Results of a prospective randomized trial conducted by the Intergroupe Francais du Myelome (IFM 90) indicated that autologous hematopoietic cell-supported high-dose therapy (HDT) effected higher complete response rates and extended progression-free survival (PFS) and overall survival (OS) compared with standard-dose therapies (SDT) for patients with multiple myeloma (MM)."

"In 1993, 3 North American cooperative groups launched a prospective randomized trial (S9321) comparing HDT (melphalan [MEL] 140 mg/m2 plus total-body irradiation 12 Gy) with SDT using the vincristine, carmustine, MEL, cyclophosphamide, and prednisone regimen. Responders on both arms ({{>=}}75%) were randomly assigned to interferon (IFN) or no maintenance treatment," explained B. Barlogie and colleagues, Southwest Oncology Group.

"With a median follow-up time of 76 months, no differences were observed in response rates between the 2 study arms (HDT, n=261 patients; SDT, n=255 patients). Similarly, PFS and OS durations did not differ between the HDT and SDT arms, with 7-year estimates of PFS of 17% and 16%, respectively, and OS of 37% and 42%, respectively. Of 242 patients achieving at least 75% tumor reduction, no difference was observed in PFS or OS among the 121 patients randomly assigned to IFN and the 121 patients randomly assigned to no maintenance therapy.

"Among 157 patients relapsing on SDT, 87 received a salvage autotransplantation; their median survival time of 30 months was only slightly better than the survival time of the remaining patients who were managed with further SDT (23 months; p=.13)," stated the scientists.

The researchers concluded, "The HDT and SDT regimens used in S9321 yielded comparable response rates and PFS and OS durations. IFN maintenance therapy did not benefit patients who achieved {{>=}}75% tumor reduction on either arm."

Barlogie and colleagues published their study in the Journal of Clinical Oncology (Standard chemotherapy compared with high-dose chemoradiotherapy for multiple myeloma: Final results of phase III US intergroup trial S9321. J Clin Oncol, 2006;24(6):929-936).

For additional information, contact B. Barlogie, Southwest Oncology Group, Operat Off, SWOG-9321, 14980 Omicron Dr., San Antonio, TX 78245, USA.

Publisher contact information for the Journal of Clinical Oncology is: American Society Clinical Oncology, 330 John Carlyle St., Ste. 300, Alexandria, VA 22314, USA.

Keywords: San Antonio, Texas, United States, Chemotherapy, Cyclophosphamide, Hematology, Hematopoietic Cells, Interferon, Multiple Myeloma, Oncology, Prednisone, Cancer Therapy, Vincristine.

This article was prepared by Clinical Oncology Week editors from staff and other reports. Copyright 2006, Clinical Oncology Week via NewsRx.com.