Trials and Tribulations in Melanoma

A phase 3 trial presented by Francesca Gay, MD, University of Torino in Italy, and colleagues, found that after induction with lenalidomide plus dexamethasone, use of high-dose alkylating agent therapy—or “double autograft”—“improves outcomes compared to use of low-dose cyclophosphamide combined with lenalidomide plus dexamethasone,” Dr Roberts reported. In maintenance therapy, however, adding prednisone to lenalidomide increased toxicity without a survival benefit (Abstract 392).

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In reporting results of the Southwest Oncology Group (SWOG) S0777 trial, Brian G. M. Durie, MD, International Myeloma Foundation and Cedars-Sinai Comprehensive Cancer Center in Los Angeles, CA, and colleagues found that both progression-free survival and overall survival are significantly improved with the addition of bortezomib to lenalidomide plus dexamethasone, with this induction regimen “a potential new standard of care,” Dr Roberts said. This benefit comes with increased neurologic, gastrointestinal, and pain-related toxicities, however (Abstract 25).

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Michel Attal, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France, and colleagues found in the Intergroupe Francophone du Myélome 2009 trial that “in the era of new drugs,” autologous transplantation for patients younger than 65 years of age newly diagnosed with multiple myeloma should remain standard of care (Abstract 391).