In the treatment of multiple myeloma, the addition of carfilzomib to a currently accepted two-drug combination produced significantly better results than using the two drugs alone, according to a worldwide research team led by investigators from the Mayo Clinic. The findings were reported online on December 6, 2014 in an open-access article in the New England Journal of Medicine, and will be presented on December 7, 2014 at the annual meeting of the American Society of Hematology (ASH), held in San Francisco. Interim analysis of the ASPIRE clinical trial, which enrolled 792 patients with relapsed multiple myeloma from 20 countries, found an "unprecedented" prolongation of the time patients were free of disease progression, says the study's lead investigator, Keith Stewart, M.B., Ch.B, a Mayo Clinic oncologist and Professor of Medicine in Arizona. "Patients taking three drugs -- carfilzomib, lenalidomide, and dexamethasone -- stayed free of disease progression for 26 months on average," he says. "No one has reported anything like this before for relapsed multiple myeloma." Researchers found that adding carfilzomib to standard treatment (lenalidomide and dexamethasone) resulted in 8.7 months of longer remission, almost 50 percent longer than the standard two-drug combination (26.3 months versus 17.6 months). The number of patients who responded to treatment was also significantly improved by adding carfilzomib to standard treatment -- 87.4 percent versus 66.9 percent-- and more than three times more patients had no detectable disease after the three-drug treatment (31.8 percent versus 9.3 percent). Although results were preliminary, there was also a trend toward improved overall survival, Dr. Stewart says. "Importantly, patients on the three-drug cocktail also reported a better quality of life despite a higher intensity of treatment," he says.
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