Patients with multiple myeloma may have a chance to live longer, going by the encouraging results of a study which demonstrates that the average survival of patients could be prolonged from the dismal 4 years to as long as 8 years.
The results of the study, led by Singapore General Hospital’s (SGH) Department of Haematology, in collaboration with Duke-NUS Graduate Medical School, National University Hospital System Singapore and Tan Tock Seng Hospital, were recently presented at the prestigious American Society of Clinical Oncology (ASCO) conference held in Chicago, USA, in June this year.
Multiple myeloma is an incurable rare blood cancer. In Singapore, about 80 new cases of myeloma are diagnosed every year. Unfortunately, most people who develop multiple myeloma have no clearly identifiable risk factors for the disease but factors such as individuals older than 50 years of age, men and obesity, may predispose one to the cancer.
With conventional treatment such as chemotherapy, including stem cell transplantation, average survival is only about 4 years. Most therapies eventually lose their effectiveness and patients inevitably suffer a relapse. Treatment options become limited and chances of remission get slimmer. In such situations, doctors may recommend repeating the same course of treatment or trying one or more of the other frontline therapies.
In 2005, a novel drug called bortezomib was approved by Singapore Health Sciences Authority and the U.S. Food and Drug Administration for use in relapsed multiple myeloma after promising results from clinical trials emerged.
The positive impact of bortezomib on relapsed patients has led doctors to wonder if other patients would benefit from the drug if it was given when they were first diagnosed.
“From what we have seen and based on our own favourable experience, we were confident that the approach of giving the drug early would work more effectively for high-risk patients who presents with unfavourable risk factors such as stage 3 multiple myeloma with damages to the kidney or patients whose myeloma cells harbour certain bad genes,” said Dr Daryl Tan, Consultant, Department of Haematology, SGH and lead investigator for the study.
The study compared survival data of 483 multiple myeloma patients who were divided into two groups – before and after bortezomib was given as frontline therapy – between 2000 and 2009. About 41 per cent of those from the second group were high-risk patients.
Their efforts paid-off this year when survival of multiple myeloma patients in Singapore was evaluated. Their strategy of offering bortezomib to high-risk patients as frontline therapy has significantly improved survival from an average of 4 years to as long as 8 years.