New agents for myeloma

Myeloma replaces cells in the marrow, leaving the appearance of holes in the bone
Myeloma replaces cells in the marrow, leaving the appearance of holes in the bone
What is the current role of interferon and rituximab in myeloma therapy?
—K. KONSTANTOPOULOS, MD, Athens

Interferon-α (IFN-α) treatment has been employed in many studies. Two separate meta-analyses of the clinical data have been published (Br J Haematol. 2001;113:1020-1034 and Ann Oncol. 2000; 11:1427-1436). Both analyses revealed a modest benefit in progression-free survival; only one demonstrated a small benefit in overall survival. These trials were performed before the year 2000, when drugs such as thalidomide and bortezomib were not available. Given the limited benefit of IFN-α, toxicity of the drug, and availability of newer agents, IFN-α is not routinely employed in the treatment of myeloma. Rituximab has been studied in phase 2 trials in patients whose plasma cells express the CD20 antigen. (For a review, see Br J Haematol. 2008;141:135-148.) There have been reports of disease stabilization and partial responses. Ongoing clinical trials are looking at combining this monoclonal antibody with other drug treatments for myeloma.
—Michael J. Flamm, MD, assistant professor of clinical medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York City
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