1. The Medical Research Council Myeloma IX trial: the impact on treatment paradigms.
- Author
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Richardson, Paul G., Laubach, Jacob P., Schlossman, Robert L., Ghobrial, Irene M., Mitsiades, Constantine S., Rosenblatt, Jacalyn, Mahindra, Anuj, Raje, Noopur, Munshi, Nikhil, and Anderson, Kenneth C.
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OSTEOSARCOMA , *MULTIPLE myeloma , *DIPHOSPHONATES , *IMPETUS theory , *PATIENTS ,PREVENTION of disease progression - Abstract
Osteolytic bone disease is a hallmark of symptomatic multiple myeloma. Bisphosphonates have been the mainstay of treatment to preserve skeletal integrity and prevent skeletal-related events in patients with myeloma-related bone disease. Recently, the MRC Myeloma IX trial demonstrated for the first time improved survival and delayed disease progression with the use of an intravenous amino-bisphosphonate, zoledronic acid, vs. an oral agent, clodronate, with intensive and non-intensive anti-myeloma treatment regimens in patients with newly diagnosed multiple myeloma. These results validate a large body of preclinical, translational and other clinical data suggesting anti-myeloma effects of amino-bisphosphonates. In addition, this trial also provided the first head-to-head evidence for superiority of one bisphosphonate over another (zoledronic acid vs. clodronate) for reducing skeletal morbidity in patients with multiple myeloma, as well as a prospective comparison of toxicities. Despite the use of non-bortezomib containing anti-myeloma treatment regimens in the MRC Myeloma IX trial, these results are encouraging and provide an impetus to continue to evaluate current treatment guidelines for myeloma-associated bone disease. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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