How is Velcade used in multiple myeloma?
Velcade is used in all stages of myeloma.
When used for as first-line treatment, Velcade is typically used in combination with dexamethasone, another anti-myeloma drug, or as part of a 3-drug combination. Examples of commonly used 3-drug combinations include Velcade-Revlimid® (lenalidomide, Celgene)-dexamethasone (VRD) or Velcade-cyclophosphamide-dex (VCD or CyBorD/Cybord).
Velcade is used alone or in combination with a variety of anti-myeloma drugs for the treatment of relapsed and/or refractory myeloma. Velcade may be used in patients who had previously responded to treatment with Velcade and who have relapsed at least 6 months after completing prior Velcade treatment.
When used as maintenance therapy, Velcade has also been shown to improve response rates following initial therapy, with or without high-dose chemotherapy and stem cell transplant, in early studies.
Velcade continues to be studied in combination with other approved myeloma drugs and in combination with new drugs in development.
What types of patients can benefit from Velcade therapy?
Velcade has been shown to be effective in a wide range of patients, including:
- Patients with previously untreated myeloma
- Patients with relapsed or refractory myeloma
- Older patients (>65 years old) as well as younger patients
- Patients with “high-risk” disease (which indicates a greater likelihood of poor prognosis)
- Patients with a type of aggressive multiple myeloma where there are changes in the patient’s DNA, including a deletion of chromosome 13 or chromosome 17 (referred to as deletion 17p), as well as other abnormalities associated with poor prognosis, such as the t(4;14) or t(14;16) translocation
- Patients who previously received Velcade
- Patients who have received several prior therapies (heavily-pretreated)
- Patients who previously received high dose chemotherapy and stem-cell transplant
- Patients with reduced kidney function (renal impairment)
- Patients with bone disease, as Velcade has been shown to have positive effects on bone
How does Velcade work?
Velcade inhibits the growth and survival of myeloma cells, leading to cell death. Data also suggest that Velcade may significantly improve bone disease in myeloma patients. Velcade’s beneficial effect on bone disease appears to be independent of whether or not a patient’s myeloma responds to Velcade.