OncoLog, Volume 56, Number 7, July 2011 Page: 4
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A New Era in Treating Patients
Who Have Multiple Myeloma
[Continued from page 3]esting research is being done as part
of a Specialized Programs of Research
Excellence grant for myeloma. Col-
laborators including Larry W. Kwak,
M.D., Ph.D., chair of and a professor
in the Department of Lymphoma
and Myeloma at MD Anderson, and
Carl June, M.D., at the University of
Pennsylvania. These researchers are
hoping to improve patients' responses
to chemotherapy by priming the im-
mune system to selectively kill myelo-
ma cells. The approach involves using
a vaccine developed from patients'
own myeloma proteins combined with
patients' T lymphocytes.
According to Dr. Wang, potentially
better chemotherapy drugs are in the
pipeline. For example, carfilzomib, a
second-generation proteasome inhibi-
tor, is being tested in a phase II clini-
cal trial at MD Anderson and other
centers in patients with relapsed or
refractory multiple myeloma who have
received one to three prior therapies
but not bortezomib.
Initial data from this trial present-
ed at the 51st Annual Meeting of
the American Society of Hematology
showed that 45% of participants res-
ponded to carfilzomib. Furthermore,
carfilzomib did not cause peripheral
neuropathy, a dose-limiting toxicity
of the older drugs thalidomide and
bortezomib. "These findings are truly
an advance for patients with multiple
myeloma," said Dr. Wang. "This is a
challenging disease with devastating
consequences. While new agents are
extending life expectancies, they often
have adverse side effects, including
severe neuropathy. Carfilzomib is
showing good response rates and an
improved side effects profile."
Carfilzomib is now being tested in
combination with lenalidomide and
dexamethasone in a phase III clinical
trial at MD Anderson. Furthermore,
the FDA has granted fast track desig-
nation for carfilzomib, which will
allow for the accelerated approval of
this drug for treating multiple myeloma.
Other new drugs for myelomabeing tested in clinical trials at MD
Anderson include panobinostat, a
nonselective histone deacetylase
inhibitor; ARRY-520, a kinesin spin-
dle protein inhibitor; and KW-2478,
a heat shock protein inhibitor. All of
these drugs act to induce cell death
through different mechanisms.
Another burgeoning area of multiple
myeloma research is genetic profiling.
In the past few years, there have been
many genetic profiling studies and
even a recent report of sequencing
the multiple myeloma genomes of 38
patients.
Although these studies are in the
early stages, Dr. Wang predicted that
genetic profiling will influence prac-
tice eventually. In fact, he said that
gross genetic features have already
changed treatments for some patients.
For example, multiple myeloma pa-
tients whose tumor cells contain chro-
mosome 13 monosomy, 17p deletion,
or some chromosome 14 transloca-
tions are considered to have high-risk
myeloma. For patients with these
chromosomal abnormalities, a more
aggressive course of treatment usually
is recommended. However, more pre-
clinical research and clinical trials will
be necessary to determine whether
certain treatments are better suited for
patients whose tumors have certain
genetic characteristics.
Thanks to the breakthroughs of
the past decade, patients with multiple
myeloma are living longer than ever
with better quality of life. Further-
more, new treatments being tested
preclinically and clinically-along
with further analysis of the genetic
profile of multiple myeloma-provide
hope for even better outcomes in the
future. "We are increasing the rate of
complete remissions and prolonging
survival," Dr. Wang said. "But our ulti-
mate goal is to one day cure multiple
myeloma." E
FOR MORE INFORMATION
Dr. Muzaffar Oazilbash ....... 713-563-7508
Dr Michael Wang...............713-792-2860Landmark Trial
Computed Tom
By Joe Munch
The preliminary results
of the National Lung
Screening Trial (NLST)
show that lung cancer
screening can be ben-
eficial to people at
high risk for the dis-
ease. However, ques-
tions remain concern-
ing who should be
screened and how
often.
Specifically, the NLST found that over
the course of the study, low-dose helical
computed tomography (CT) offered a lung
cancer-specific mortality reduction of
20.3% and an all-cause mortality reduc-
tion of 6.9% compared with standard
chest radiography in people considered to
be at high risk for lung cancer. The clini-
cal practice implications of these and
other findings from the trial may not be
known for some time, however.
Reginald Munden, M.D., a professor in
the Department of Diagnostic Radiology
at The University of Texas MD Anderson
Cancer Center, was the study's principal
investigator at the institution.
"The trial provided a very rich reposi-
tory of data, probably more data than we
will ever be able to fully understand," Dr.
Munden said. "Even though we are in the
very early phases of understanding lung
cancer screening, this trial is still the most
significant thing that's ever happened in
lung cancer because now we can detect a
cancer early enough to cure somebody."
Still, Dr. Munden said, "The trial
may have raised more questions than it
answered."4 OncoLog * July 2011
4
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University of Texas M.D. Anderson Cancer Center. OncoLog, Volume 56, Number 7, July 2011, periodical, July 2011; Houston, Texas. (https://texashistory.unt.edu/ark:/67531/metapth639573/m1/4/: accessed July 17, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.