PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Study: Older multiple myeloma patients can be spared of long-term steroids

Phase III study shows benefits of using age and functional status to guide, modify treatment approach

2021-03-19
(Press-News.org) The combination of cancer therapy lenalidomide plus the steroid dexamethasone (together called Rd) is considered standard treatment for elderly patients with multiple myeloma. However, prolonged steroid use can be harmful for some older adults.

A new study published in Blood found that switching select older patients to a lower dose of lenalidomide and discontinuing dexamethasone after nine months was not only safe, but it also yielded similar outcomes as compared with patients who received continuous Rd.

Multiple myeloma, a cancer affecting the blood plasma cells (a type of white blood cell in the bone marrow), most commonly occurs in people over 60. Because of patients' older age, they are generally more susceptible to adverse events due to a higher likelihood of having other health conditions or functional impairments, and some treatments affect the body differently as we age.

This phase III clinical trial involved 33 medical centers in Italy and is the first to evaluate an adapted Rd treatment schedule that spares steroid use in older patients. Participants included people with newly diagnosed multiple myeloma (median age 76) who were deemed intermediate fitness for treatment, either because of their age or deficits in their ability to perform activities of daily living, such as bathing or dressing.

"Myeloma patients are a very diverse population, including fit patients who may tolerate full-dose treatments, and intermediate-fit and frail patients who are more susceptible to adverse events that may negatively affect the duration and outcome of treatment due to the presence of comorbidities and functional impairments, thus requiring an adapted therapy," said lead author Alessandra Larocca, MD, PhD of the University of Turin in Italy. "Our study shows, for the first time, that reducing the dose or intensity of treatment is a feasible option and produces similar outcomes as standard dose treatments for intermediate-fit patients."

Nowadays, multiple myeloma patients usually receive continuous treatment including steroids, which are typically given until a patient's disease progresses or they are unable to tolerate the therapy, according to Dr. Larocca. But as she explained, "Prolonged steroid use is scarcely tolerated in the long term, even in younger patients, and patients may often require dose reduction or interruption."

In fact, long-term use of dexamethasone-based regimens have been associated with insomnia, anxiety, agitation, weight gain, and swelling (edema) in the legs.

Finding ways to adapt treatments for older patients and those with functional deficits to allow them to remain on treatment longer and maintain disease control is critically important. As such, researchers wanted to evaluate whether stopping dexamethasone early, after initial therapy, and tapering the dose of lenalidomide (to 10 mg/day) would still benefit older intermediate-fit patients with newly diagnosed multiple myeloma who were not eligible for transplantation.

A total of 199 patients were enrolled and randomized to one of two study groups between October 2014 and October 2017. Only individuals deemed intermediate-fit were eligible for the study; patients were excluded if they were considered to be either fit or frail based on the International Myeloma Working Group frailty scale. Of these participants, 98 were randomized to receive continuous Rd and 101 received the adjusted dose and schedule after nine Rd induction cycles (called induction therapy).

After a median follow-up of 37 months, those who were no longer taking dexamethasone experienced a significantly longer period without an adverse event or relapse compared with those who continued on the standard Rd therapy (event-free survival of 10.4 months vs. 6.9 months, respectively). The tailored approach was also better tolerated, resulting in fewer adverse effects. Of the adverse events observed on the tailored approach, most were minor, including low white blood cell counts, infections, and skin disorders. The groups showed similar response rates, as well as similar chances of staying free of disease progression.

The findings could have important implications for practice. Dr. Larocca estimates that about one-third of myeloma patients not eligible for stem cell transplantation, a risky but common and effective treatment approach, fit the criteria used in this study.

"We expect the results of this study may help to improve and optimize the treatment of elderly patients who may be at greater risk of treatment toxicity and poor survival due to their age or comorbidities," she said, adding that ongoing trials are now evaluating steroid sparing in combination with monoclonal antibody or the role of frailty-guided treatment.

INFORMATION:



ELSE PRESS RELEASES FROM THIS DATE:

Intelligent insect counter opens new opportunities for nature monitoring

2021-03-19
3,938 moths are part of a major insect study based on artificial intelligence, and researchers from Aarhus University have just published their results in the scientific journal Sensors. They have developed a counting machine that uses ultraviolet light to attract insects and register them with image recognition. The invention may have a decisive impact on research into climate change and biodiversity. "If we can monitor the development of moth populations, we can gain new knowledge about how climate change affects our nature. Our technology takes an important step towards automating the very extensive work entailed in counting insects," ...

Virtual reality could help to reduce pain for people with nerve injuries

2021-03-19
We all feel physical pain in different ways, but people with nerve injuries often have a dysfunctional pain suppression system, making them particularly prone to discomfort. Now researchers have uncovered that virtual reality (VR) can reduce types of pain typically seen in patients with nerve injuries - and that VR can boost the dysfunctional pain suppression system, giving people with chronic pain a possible game-changing hope. Dr Sam Hughes, Lecturer in Psychology at the University of Plymouth, led the study focusing on conditioned pain modulation ...

A new dye shakes up solar cells

A new dye shakes up solar cells
2021-03-19
In 1991, scientists Brian O'Regan and Michael Grätzel at EPFL published a seminal paper describing a new type of solar cell: the dye-sensitized solar cell (DSSC), also known as "Grätzel cell". Simple and cheap to build while being flexible and versatile, DSSCs are already manufactured on a multi-megawatt scale, cutting a significant slice of the photovoltaic market, which currently supplies almost 3% of all the world's electricity, well in the race to reduce carbon emissions. Now, Dan Zhang and Marko Stojanovic, two PhD students in Grätzel's lab at EPFL's School of Basic Sciences, have led the development of a simple dye for DSSCs, called MS5. In devices, this new sensitizer can either be used as single dye, ...

TPU scientists offer new plasmon energy-based method to remove CO2 from atmosphere

2021-03-19
Researchers from Tomsk Polytechnic University jointly with their colleagues from the Czech Republic have found a method to synthesize cyclic carbonates from atmospheric CO2. Cyclic carbonates are organic compounds, used as electrolytes for lithium-ion batteries, green solvents as well as in pharmaceutical drugs manufacturing. The scientists managed to synthetize carbonates under sunlight and at room temperature, while conventional methods require synthesis under high pressure and temperatures. The research findings are published in Journal of Materials Chemistry A (IF:11,301; Q1). "The increase in CO2 levels in the atmosphere is a global environmental problem. The solutions of the problem are usually focused on measures to reduce CO2 emissions. An alternative method is to use the CO2 already ...

How flashlight fish communicate with light signals in the school

How flashlight fish communicate with light signals in the school
2021-03-19
Flashlight fish have the ability to generate situation-specific blink patterns resembling a visual Morse code. Researchers at Ruhr-Universität Bochum have shown in laboratory and field experiments that the animals use these light signals to coordinate their behaviour in the school when visibility is limited. Both the light intensity and the blinking frequency affected the animals' behaviour. The team headed by Peter Jägers and Professor Stefan Herlitze from the Department of General Zoology and Neurobiology has shared their findings in the journal Scientific Reports, published online on 19 ...

Health declining in Gen X and Gen Y, national study shows

2021-03-19
COLUMBUS, Ohio - Recent generations show a worrying decline in health compared to their parents and grandparents when they were the same age, a new national study reveals. Researchers found that, compared to previous generations, members of Generation X and Generation Y showed poorer physical health, higher levels of unhealthy behaviors such as alcohol use and smoking, and more depression and anxiety. The results suggest the likelihood of higher levels of diseases and more deaths in younger generations than we have seen in the past, said Hui Zheng, ...

Important advance in research on future drugs

2021-03-19
Most drugs operate via the membranes that surround the body's cells. A study by researchers at Karolinska Institutet in Sweden has now mapped the structure and mechanism of MGST2, a membrane enzyme that, amongst other things, plays a part in chronic inflammation and cancer. The study, which is published in the journal Nature Communications, can make a significant contribution to the development of future drugs. All our cells are enclosed in a fat-rich membrane. The cells' equivalent to organs, the organelles, are also enclosed by membranes. Embedded in the cell's internal and external membranes are proteins that regulate a large number of vital functions. ...

Parkinson's disease: When molecular guardians need to be protected

Parkinsons disease: When molecular guardians need to be protected
2021-03-19
Parkinson's disease is the second most common, age-related, neurodegenerative disease: In Germany alone, about 300,000 people are affected and experience sometimes major limitations to their quality of life. Although Parkinson's is so widespread, there is still no treatment that targets the cause of the disease and can stop it in its tracks. However, current research provides new hope: A research team at the University of Konstanz led by Professor Marcus Groettrup describes a new approach for developing future treatments for Parkinson's. The biologists demonstrated that the ubiquitin-like ...

New research shows substantially higher burden of COVID-19 compared to flu

2021-03-19
Boston, Mass. - In a paper published in the Journal of General Internal Medicine, physician-researchers at Beth Israel Deaconess Medical Center (BIDMC) assessed the relative impact of COVID-19 on patients hospitalized with the viral infection in March and April 2020, versus patients hospitalized with influenza during the last five flu seasons at the medical center. Overall, the team demonstrated that COVID-19 cases resulted in significantly more weekly hospitalizations, more use of mechanical ventilation and higher mortality rates than influenza. COVID-19 and influenza are both contagious respiratory viral diseases that can lead to pneumonia and acute respiratory failure in severe cases. However, detailed comparison of the epidemiology and clinical characteristics of COVID-19 ...

Difficulty learning nonsense words may indicate a child's high risk of dyslexia

2021-03-19
Researchers at Aalto University and the Niilo Mäki Institute have used neuroimaging to pinpoint where the brain activates - or doesn't activate - among children identified as having a high risk of dyslexia. Magnetoencephalography (MEG) has rarely been used to study the reading disorder in children. The brain study was carried out at Aalto University by measuring brain activity with MEG, which measures the weak magnetic fields arising from electrical activity in the brain, over a period of two days. Earlier studies have shown that difficulties in processing sounds may be partly responsible for dyslexia, and that these challenges may relate to the left auditory cortex which processes language. During the study, the children listened to nonsensical ...

LAST 30 PRESS RELEASES:

Multi-resistance in bacteria predicted by AI model

Tinker Tots: A citizen science project to explore ethical dilemmas in embryo selection

Sensing sickness

Cost to build multifamily housing in California more than twice as high as in Texas

Program takes aim at drinking, unsafe sex, and sexual assault on college campuses

Inability to pay for healthcare reaches record high in U.S.

Science ‘storytelling’ urgently needed amid climate and biodiversity crisis

KAIST Develops Retinal Therapy to Restore Lost Vision​

Adipocyte-hepatocyte signaling mechanism uncovered in endoplasmic reticulum stress response

Mammals were adapting from life in the trees to living on the ground before dinosaur-killing asteroid

Low LDL cholesterol levels linked to reduced risk of dementia

Thickening of the eye’s retina associated with greater risk and severity of postoperative delirium in older patients

Almost one in ten people surveyed report having been harmed by the NHS in the last three years

Enhancing light control with complex frequency excitations

New research finds novel drug target for acute myeloid leukemia, bringing hope for cancer patients

New insight into factors associated with a common disease among dogs and humans

Illuminating single atoms for sustainable propylene production

New study finds Rocky Mountain snow contamination

Study examines lactation in critically ill patients

UVA Engineering Dean Jennifer West earns AIMBE’s 2025 Pierre Galletti Award

Doubling down on metasurfaces

New Cedars-Sinai study shows how specialized diet can improve gut disorders

Making moves and hitting the breaks: Owl journeys surprise researchers in western Montana

PKU Scientists simulate the origin and evolution of the North Atlantic Oscillation

ICRAFT breakthrough: Unlocking A20’s dual role in cancer immunotherapy

How VR technology is changing the game for Alzheimer’s disease

A borrowed bacterial gene allowed some marine diatoms to live on a seaweed diet

Balance between two competing nerve proteins deters symptoms of autism in mice

Use of antifungals in agriculture may increase resistance in an infectious yeast

Awareness grows of cancer risk from alcohol consumption, survey finds

[Press-News.org] Study: Older multiple myeloma patients can be spared of long-term steroids
Phase III study shows benefits of using age and functional status to guide, modify treatment approach