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Archive - Dec 6, 2014

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Unprecedented Benefit Seen in Three-Drug Treatment for Multiple Meloma

In the treatment of multiple myeloma, the addition of carfilzomib to a currently accepted two-drug combination produced significantly better results than using the two drugs alone, according to a worldwide research team led by investigators from the Mayo Clinic. The findings were reported online on December 6, 2014 in an open-access article in the New England Journal of Medicine, and will be presented on December 7, 2014 at the annual meeting of the American Society of Hematology (ASH), held in San Francisco. Interim analysis of the ASPIRE clinical trial, which enrolled 792 patients with relapsed multiple myeloma from 20 countries, found an "unprecedented" prolongation of the time patients were free of disease progression, says the study's lead investigator, Keith Stewart, M.B., Ch.B, a Mayo Clinic oncologist and Professor of Medicine in Arizona. "Patients taking three drugs -- carfilzomib, lenalidomide, and dexamethasone -- stayed free of disease progression for 26 months on average," he says. "No one has reported anything like this before for relapsed multiple myeloma." Researchers found that adding carfilzomib to standard treatment (lenalidomide and dexamethasone) resulted in 8.7 months of longer remission, almost 50 percent longer than the standard two-drug combination (26.3 months versus 17.6 months). The number of patients who responded to treatment was also significantly improved by adding carfilzomib to standard treatment -- 87.4 percent versus 66.9 percent-- and more than three times more patients had no detectable disease after the three-drug treatment (31.8 percent versus 9.3 percent). Although results were preliminary, there was also a trend toward improved overall survival, Dr. Stewart says. "Importantly, patients on the three-drug cocktail also reported a better quality of life despite a higher intensity of treatment," he says.

Smoking Associated with Mosaic Loss of Y-Chromosome

In a new study, published online on December 4, 2014 in Science, researchers at Uppsala University, and collaborators, demonstrate an association between smoking and loss of the Y-chromosome (image) in blood cells. The researchers have previously shown that loss of the Y-chromosome is linked to cancer. Because only men have the Y-chromosome, these results might explain why smoking is a greater risk factor for cancer among men and, in the broader perspective, also help explain why men in general have shorter lifespans. Smoking is a risk factor for various diseases, not only lung cancer. Epidemiological data show that male smokers have a greater risk of developing cancer outside the respiratory tract than female smokers. In the present study, which is the result of an international collaboration, the researchers discovered an association between smoking and genetic damage among men that might explain this sex difference. “We have previously in 2014 demonstrated an association between loss of the Y-chromosome in blood and greater risk for cancer. We now tested if there were any lifestyle- or clinical factors that could be linked to loss of the Y-chromosome. Out of a large number of factors that were studied, such as age, blood pressure, diabetes, alcohol intake, and smoking, we found that loss of the Y-chromosome in a fraction of the blood cells was more common in smokers than in non-smokers,” says Lars Forsberg, Ph.D., researcher in the Department of Immunology, Genetics, and Pathology, Uppsala University, and the key scientist responsible for the study. The association between smoking and loss of the Y chromosome was dose-dependent, i.e. loss of the Y-chromosome was more common in heavy smokers compared to moderate smokers.