Thalidomide resurfaces as treatment for multiple myeloma
Drug derivative may prolong life of people battling uncurable type of bone marrow cancer
Last Updated: Thursday, November 22, 2007 | 3:30 PM ET
CBC News
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'I'm willing to try anything to see if we can get this cancer under control.'— Derek Hunter
A derivative of thalidomide may prolong life in people with a type of bone marrow cancer called multiple myeloma — if taken with a steroid — a new study finds.
Called lenalidomide, the drug, in combination with the steroid dexamethasone, can slow the progress of the incurable bone marrow cancer and extend the lives of patients with the condition by an average of 10 months, the research suggests.
Multiple myeloma is a cancer of a type of white blood cell in the bone marrow. It is the second most prevalent blood cancer after non-Hodgkin's lymphoma, according to Myeloma Canada, with approximately 14,000 newly diagnosed cases in the United States annually.
The study, published in the Nov. 22 issue of the New England Journal of Medicine, was conducted by researchers at 44 medical centres in Canada and the U.S and involved 353 patients.
The research was funded by Celgene, the manufacturer of thalidomide, which this week announced a $2.9-billion buyout of Pharmion, a biopharmaceutical manufacturer that has been working with Celgene in marketing thalidomide as a cancer treatment.
Between 1957 and 1962, thalidomide was prescribed to treat morning sickness in pregnant women. Worldwide, 10,000 people were born with missing or shrunken limbs, and came to be known as "thalidomide babies."
In Canada alone, it's estimated that about 100 babies were born with severe deformities after their mothers took the drug during their pregnancies. The drug was pulled from Canadian pharmacies in 1962.
Thalidomide welcome news for patients with few options
But in the case of multiple myeloma, which progresses quickly, lenalidomide is welcome news. Halfway through the study, an independent interim data review led to the clinical trial being halted to allow those participants on placebos to be administered the drug.
Of the 177 patients who received lenalidomide and dexamethasone, 108 had "complete, near-complete or partial responses" to the drugs, versus 35 in the control group of 176 that received a placebo and dexamethasone.
The study led the U.S. Food and Drug Administration to approve lenalidomide and dexamethasone in 2006.
Dr. Darrell White, a hematologist with the Queen Elizabeth II Health Sciences Centre in Halifax and one of the Canadian investigators in the study, told CBC News that multiple myeloma patients typically have relapses as their treatments become ineffective over time.
"So for these patients with this incurable malignancy, this means they have another effective treatment that they can move onto," he said.
Derek Hunter, a 66-year-old resident of St. John, N.B., was diagnosed with multiple myeloma four years ago. When two stem cell transplants failed, he was given the chance to receive lenalidomide as part of a North American clinical trial.
Despite thalidomide's history, Hunter didn't hesitate. "My options were limited to say the least, and at that point I said 'Look, I'm willing to try anything to see if we can get this cancer under control.'"
He has been taking lenalidomide since last February. He says the bone marrow cancer, while incurable, is now under control.
"For the time being, I couldn't ask for anything better," he said.
The drug is not approved for use in Canada, although Health Canada is reviewing an application from the manufacturer. If it is approved, it will cost thousands of dollars a month. It will also be tightly controlled due to serious and potentially toxic side effects.
These include the suppression of white blood cells, leaving patients less able to fight infections, and the formation of blood clots.
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