Five-drug combination for ultra-high-risk bone marrow cancer identified

A team at The Institute of Cancer Research (ICR), London and the Clinical Trials Research Unit (CTRU) at the University of Leeds adopted a new high-speed trial methodology.

A combination of five drugs, already available individually in clinics, have been shown to successfully slow the progression of a highly aggressive myeloma. A major new clinical trial has identified the five-drug cocktail, which along with a stem cell transplant, allows people with ultra-high-risk multiple myeloma to live longer before their disease progressed, than those who received the standard of care.

The team at the ICR and the CTRU tested the five-drug combination against the findings of an earlier study to obtain the results faster for the eventual benefit of patients.

Multiple myeloma–also known as myeloma–is a type of cancer. Myeloma takes place in the plasma cells in the bone marrow, causing bone pain in the chest or spine, weakened bones, fatigue, nausea, constipation, frequent infections and weight loss. The cancer often impacts several areas of the body including the spine, skill, pelvis and ribs.

Bortezomib, lenalidomide, daratumumab, dexamethasone and cyclophosphamide chemotherapy, the five drugs in the combination, are individually licensed and in clinical use. This gives the combination the potential to receive a streamlined approval and become available to patients relatively quickly.

“We know that patients with multiple myeloma who have ‘ultra-high risk’ genetic signatures have particularly aggressive cancers that fail to respond to standard treatment. In this study, we have identified a new five-drug combination that can keep myeloma at bay for longer in these patients,” Study leader Dr Martine Kaiser, team leader in myeloma molecular therapy at The Institute of Cancer Research, London and consultant haematologist at The Royal Marsden NHS Foundation Trust said: “Our study shows the benefit of genetic testing in patients with myeloma to identify those at highest risk, since we now have a new and better treatment option for these people.”

The new findings represent a significant advance for patients with high-risk myeloma and highlight the need to tailor therapy to the genetic makeup of each patient’s cancer, which is not currently done routinely.