Adding a second drug to standard chemotherapy treatment can help patients diagnosed with an aggressive type of bone marrow cancer live longer, according to a major study published online in the Lancet today.
Around 4,000 British people are diagnosed each year with multiple myeloma, a cancer that affects a type of white blood cell in the bone marrow called plasma cells. Average survival after diagnosis is just three to five years so new treatments are urgently needed.
Professor Gareth Morgan from The Institute of Cancer Research (ICR) and The Royal Marsden Hospital led a Phase III study of 1960 newly-diagnosed multiple myeloma patients comparing a zoledronic acid treatment called Zometa, developed by Novartis, with another standard approved treatment called clodronic acid. All patients were also given chemotherapy. The trial, known as the Medical Research Council (MRC) Myeloma IX study, ran from May 2003 until November 2007 with funding from the MRC and support from Novartis, Schering Health Care, Chugai, Pharmion, Celgene and Ortho Biotech.
Patients in the zoledronic acid group lived an average of 5.5 months longer than patients in the clodronic acid group (50 months versus 44.5 months). Patients in the test group were 16 per cent less likely than those in the control group to succumb to the disease during the average 3.7 years they took part in the study and subsequent follow-up. Zoledronic acid also reduced by 24 per cent the development of new bone lesions compared to clodronic acid.
“Our study suggests that zoledronic acid has the potential to help newly-diagnosed multiple myeloma patients live longer, and provides strong evidence that it should become part of the new gold standard care,” said Professor Morgan.
Zoledronic acid and clodronic acid are both bisphosphonates, which are already prescribed to cancer patients to reduce bone complications such as fractures, lesions and spinal cord compression. Bisphosphonates work by breaking the cycle of bone destruction and cancer growth that can cause these complications. Both drugs are already approved in the UK for multiple myeloma patients, for whom such complications are common as the cancer cells live inside the bones.
Using statistical analysis, the researchers confirmed previous laboratory findings that zoledronic acid can have an effect on cancer cells independently of these bone complications.
Side-effects for zoledronic acid, which is administered intravenously, are known to be generally mild. In this study the two drugs gave similar side-effects, although patients taking zoledronic acid had a three per cent higher risk of jaw osteonecrosis. More than 3.5 million patients worldwide have already been given zoledronic acid to treat bone complications.
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The Institute of Cancer Research (ICR)
