News Release

Thalidomide improves survival of elderly with multiple myeloma when added to chemotherapy regimen

Peer-Reviewed Publication

The Lancet_DELETED

The addition of thalidomide to the standard combination chemotherapy treatment of melphalan plus prednisone for elderly patients with multiple myeloma significantly improves survival. This is the conclusion of authors of an Article published in this week’s edition of The Lancet.

Combination chemotherapy with melphalan and prednisone (MP) has been used in the treatment of multiple myeloma since the 1960s, and still remains the most widely accepted treatment option for elderly patients who are ineligible for high-dose therapy.

Professor Thierry Facon, Hôpital Claude Huriez, Centre Hospitalier Universitaire de Lille, Lille, France, and colleagues from the Intergroupe Francophone du Myélome (IFM) did a study of 447 previously untreated patients with multiple myeloma, aged between 65 and 75 years. Of these, 196 were randomised to receive MP, 125 to receive MP plus thalidomide (MPT), and 126 to receive reduced-intensity stem cell transplantation using melphalan (MEL100).

After a median follow-up of 51.5 months, median overall survival times were 33.2 months for MP, 51.6 months for MPT, and 38.3 for MEL100. The MPT regimen was thus associated with significantly better overall survival, with MPT patients 41% less likely to die than MP patients and 31% less likely to die than MEL100 patients.

The authors say: “Our study has shown that the addition of thalidomide to standard melphalan and prednisone significantly extended survival for elderly patients with previously untreated multiple myeloma. We noted that the MPT regimen was better than the MP regimen in terms of response, including complete response, overall survival, and progression-free survival.”

They conclude: “The results of our trial provide strong evidence to suggest that the MPT combination, should, at present, be the reference treatment for previously untreated elderly patients with multiple myeloma. After 40 years of unsuccessful attempts to find a more effective treatment than the standard MP, the MPT combination opens an era of progress for elderly patients with this disease.”

In an accompanying Comment, Dr Antonio Palumbo and Dr Mario Boccadoro, University of Torino, Italy, agree. They say: “After 50 years of unsuccessful attempts to find new and more effective treatment approaches suitable for most patients, we now have extensive evidence to support the introduction of MPT as the standard of care for elderly patients with multiple myeloma.”

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Full contacts

Professor Thierry Facon, Hôpital Claude Huriez, Centre Hospitalier Universitaire de Lille, Lille, France T) +33 3 20 44 57 12 E) t-facon@chru-lille.fr

Dr Antonio Palumbo, University of Torino, Italy T) +39 0116334260 E) appalumbo@yahoo.com

The paper can be viewed at the link below:
http://multimedia.thelancet.com/pdf/press/thalidomide.pdf


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