Drug combo doubles myeloma survival rate

About 1 in 10 patients in multi-centre Asian clinical trial also achieved near remission

A new drug combination tested in an Asian clinical trial has doubled the survival rates of myeloma cancer patients who do not respond well to standard treatment.

About half of the 136 patients who took part in the trial lived for at least 14 months. This is more than double the survival rate expected of these patients.

About one in 10 participants also achieved near remission.

The clinical trial, AMN 0001, is believed to be the largest multi-centre one conducted in Asia. It was carried out in Japan and Taiwan, among other places, and also involved 24 patients from Singapore.

The trial was led by Professor Chng Wee Joo from the National University Cancer Institute, Singapore (NCIS). It was conducted by the Asian Myeloma Network, which brings clinical trials to cancer patients in Asia, providing them early access to drugs which may not yet be approved.

Patients who took part in the trial were considered to have "end stage" cancers and had relapsed despite having gone through an average of four rounds of treatment.

Myeloma is a rare cancer of the blood, with about 120 new cases here every year.

There is no cure for the disease, and its incidence has been increasing by 10 to 15 per cent over the past few years.

During the trial, conducted from December 2014 to February this year, patients were given Pomalidomide, an immunomodulatory drug, and Dexamethasone, a steroid. An immunomodulatory drug increases the immune system's ability to attack cancer cells.

Patients who did not respond well to the drugs after three cycles of treatment were allowed to add on another mild chemotherapy drug during the trial.

Apart from achieving good results, trial participants experienced mild side effects of low blood count and rashes; patients undergoing chemotherapy usually experience pain, nausea and vomiting.

Over the past five years, six new drugs which have been shown to be effective for myeloma patients have been introduced in the West.

However, new drugs take a longer time to be approved for use here and are also expensive.

For example, taking Pomalidomide for a month will cost a patient about $10,000.

Said Prof Chng, NCIS centre director and the AMN 0001 trial's lead investigator: "With such trials, patients can get access to these drugs for free. Over the longer term, we hope to contribute towards making such drugs more accessible to patients who need them."

Mr Edmund Tai, 68, who was diagnosed with myeloma in June 2013, benefited from the trial.

He used to work in the freight forwarding business and had gone through various treatments, including 10 cycles of chemotherapy at Tan Tock Seng Hospital, but did not respond well to them.

He is now undergoing treatment at NCIS, where he sees Prof Chng once a month.

Asked why he decided to enrol in the trial, Mr Tai said: "I was going nowhere, so I thought there's no point wasting time on chemotherapy since it wasn't working."

NCIS hopes to launch three other clinical trials for myeloma patients through the Asian Myeloma Network by the end of this year. Once the trials are available, they will be made known on the NCIS website.

A version of this article appeared in the print edition of The Straits Times on March 22, 2017, with the headline 'Drug combo doubles myeloma survival rate'. Print Edition | Subscribe