How is Doxil used in multiple myeloma?
Doxil® (doxorubicin HCl liposome injection, Janssen) is typically used with other anticancer agents to treat cancer. Doxil is often used in place of conventional doxorubicin, and it is also used as part of novel combination therapies.
Doxil is approved by the FDA for use in combination with Velcade® (bortezomib, Takeda Oncology) to treat patients with myeloma who have not previously received Velcade and have received at least one prior therapy. Results of clinical trials show that that adding Doxil to a standard Velcade regimen reduced the risk of the disease progressing and prolonged the duration of response in patients with relapsed and refractory disease better than Velcade alone.
Doxil is being studied in combination with other approved myeloma drugs and in combination with new drugs in development for the treatment of relapsed and/or refractory myeloma. Doxil is also being studied as part of combination therapies for the treatment of newly diagnosed or previously untreated myeloma, also referred to as frontline therapy.
How does Doxil work?
Doxil is a reformulated version of the drug doxorubicin (Adriamycin®). Doxorubicin is a chemotherapy agent that belongs to a class of agents referred to as anthracyclines. Anthracyclines are used to treat cancer because they damage the DNA in cancer cells and cause them to die.
With Doxil, the doxorubicin is wrapped in a “fat bubble” (liposome), which serves to help slowly release the drug and may help reduce side effects. The liposomes are also coated with another substance, a process called pegylation, which helps the liposomes stay in the circulation longer.
What types of patients can benefit from Doxil therapy?
Results of the clinical trial that led to Doxil’s approval showed that the combination of Doxil and Velcade is effective in a wide range of patients with relapsed/refractory myeloma, including:
- Older patients (≥65 years old) as well as younger patients
- Patients who have previously received a stem cell transplant
- Patients who have previously received Thalomid® (thalidomide, Celgene) or Revlimid® (lenalidomide, Celgene)
- Patients who have previously received doxorubicin
- Patients with “high-risk” disease (poor prognosis)
- Velcade-Doxil was beneficial to patients with chromosome abnormalities and those with elevated levels of beta 2-microglobulin
- Patients with impaired renal (kidney) function