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The Medical Research Council Myeloma IX trial: the impact on treatment paradigms *
Author(s) -
Richardson Paul G.,
Laubach Jacob P.,
Schlossman Robert L.,
Ghobrial Irene M.,
Mitsiades Constantine S.,
Rosenblatt Jacalyn,
Mahindra Anuj,
Raje Noopur,
Munshi Nikhil,
Anderson Kenneth C.
Publication year - 2012
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.2011.01721.x
Subject(s) - multiple myeloma , medicine , zoledronic acid , bisphosphonate , bone disease , bortezomib , clinical trial , oncology , myeloma protein , osteoporosis
Osteolytic bone disease is a hallmark of symptomatic multiple myeloma. Bisphosphonates have been the mainstay of treatment to preserve skeletal integrity and prevent skeletal‐related events in patients with myeloma‐related bone disease. Recently, the MRC Myeloma IX trial demonstrated for the first time improved survival and delayed disease progression with the use of an intravenous amino‐bisphosphonate, zoledronic acid, vs. an oral agent, clodronate, with intensive and non‐intensive anti‐myeloma treatment regimens in patients with newly diagnosed multiple myeloma. These results validate a large body of preclinical, translational and other clinical data suggesting anti‐myeloma effects of amino‐bisphosphonates. In addition, this trial also provided the first head‐to‐head evidence for superiority of one bisphosphonate over another (zoledronic acid vs. clodronate) for reducing skeletal morbidity in patients with multiple myeloma, as well as a prospective comparison of toxicities. Despite the use of non‐bortezomib containing anti‐myeloma treatment regimens in the MRC Myeloma IX trial, these results are encouraging and provide an impetus to continue to evaluate current treatment guidelines for myeloma‐associated bone disease.