Celgene's Revimid promising in myeloma

Shortly after Millennium reported encouraging clinical trial results forits investigational multiple myeloma drug at the American Society of Hematology meeting (see story above), another promising therapy for the disease, Celgene's Revimid, threw its hat into the ring. Revimid is an analog of thalidomide, a drug which is also used in the treatment of multiple myeloma on the basis of its ability to inhibit cell cycling and angiogenesis; new blood vessel formation in the bone marrow is a hallmark of multiple myeloma.

The 24-patient study enrolled individuals with rapidly-advancing refractory multiple myeloma, 16 of whom had failed prior treatment with thalidomide. All the patients had seen their disease progress despite at least two prior treatment regimens. Patients were treated with Revimid given orally at one of four doses - 5mg, 10mg, 25mg or 50mg/day - for an initial period of 28 days. At this point, responders were allowed to continue on the treatment.

After 28 days, 79% of the patients achieved stable disease or better, while 63% experienced a greater than 25% reduction in M protein (paraprotein) levels. No dose-limiting toxicities were observed at any of the dose levels tested in the initial treatment period, although dose reductions were required for grade 3 thrombocytopenia and grade 3/4 neutropenia in the extension phase. Commonly-observed side effects with thalidomide, such as somnolence, constipation and neuropathy, were not encountered.