Thalidomide improves myeloma survival in elderly

NEW YORK (Reuters Health) - Treatment with thalidomide, a drug made infamous decades ago for its link with severe birth defects, can improve the survival of elderly patients with multiple myeloma, a cancer affecting cells in the bone marrow, new research shows.

As reported in The Lancet, Dr. Thierry Facon, from Hopital Claude Huriez in Lille, France, and colleagues assessed survival in 447 previously untreated patients, between 65 and 75 years of age, who were treated with standard chemotherapy, either alone or combined with thalidomide, or with bone marrow transplantation. The subjects were followed for about 51 months.

Patients treated with thalidomide survived roughly 13 to 18 months longer than did other patients, the investigators found. Overall, treatment with thalidomide cut the risk of death by 41 and 31 percent compared with standard chemotherapy alone and transplantation, respectively.

"The results of our trial provide strong evidence to suggest that (thalidomide combined with standard chemotherapy) should, at present, be the reference treatment for previously untreated elderly patients with multiple myeloma," the researchers conclude.

The authors of a related editorial agree with this conclusion. "After 50 years of unsuccessful attempts to find new and more effective treatment approaches suitable for most patients, we now have extensive evidence to support the introduction of (thalidomide plus chemotherapy) as the standard of care for elderly patients with multiple myeloma," state Dr. Antonio Palumbo and Dr. Mario Boccadoro, from Azienda Ospedaliera San Giovanni Battista in Torino, Italy.

SOURCE: The Lancet, October 6, 2007.