Myeloma Drug Works Better at Lower Dose

ByABC News
March 23, 2008, 11:26 PM

Mar. 23 -- FRIDAY, April 6 (HealthDay News) -- Proving that less really can be more, U.S. government researchers say that a lower dose of chemotherapy raises the survival of patients with the blood cancer multiple myeloma.

In fact, one-year survival rose so dramatically -- from 86 percent to 96 percent -- for patients receiving a lower dose of the steroid dexamethasone in a National Cancer Institute clinical trial that the trial was prematurely halted so all participants could reap the potential benefit.

Patients were receiving the lower-dose steroid alongside another cancer-fighting drug, lenalidomide, a chemical cousin of thalidomide.

"This treatment reduces the risk of side effects and, at the same time, it is more effective, demonstrating that more is not always better," said Dr. Len Lichtenfeld, chief medical officer with the American Cancer Society. He was not involved with the study.

The study results have not yet been published, but the full dataset will be presented in June at the annual meeting of the American Society of Clinical Oncology in Chicago. The one-year, preliminary results of this two-year study were released earlier this week for the benefit of patients struggling with multiple myeloma, the researchers said.

The disease, a malignancy of plasma cells residing in the bone marrow and bloodstream, is diagnosed in almost 20,000 Americans each year, according to the NCI.

According to Lichtenfeld, myeloma patients are typically given one of 14 treatment options, depending on the type and stage of their disease.

Beginning in the mid-1990s, scientists began to realize that the drug thalidomide might help fight myeloma, primarily through its effect in shrinking the cancer's blood supply.

According to study co-researcher Dr. Howard Streicher, drugs such as thalidomide may also inhibit myeloma by interfering with key signaling molecules called cytokines, or by boosting immune responses.

Thalidomide has a checkered past, however, most notably as the cause of devastating birth defects.