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	<title>Symptom Advice .com &#187; melphalan</title>
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		<title>Overall Survival Benefit with VELCADE® Based Therapy in Previously Untreated Multiple Myeloma Patients Maintained After Five Year Follow-Up</title>
		<link>http://symptomadvice.com/overall-survival-benefit-with-velcade%c2%ae-based-therapy-in-previously-untreated-multiple-myeloma-patients-maintained-after-five-year-follow-up/</link>
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		<pubDate>Tue, 13 Dec 2011 23:51:10 +0000</pubDate>
		<dc:creator>Symptom Advice</dc:creator>
				<category><![CDATA[liver symptoms]]></category>
		<category><![CDATA[melphalan]]></category>
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		<category><![CDATA[survival advantage]]></category>
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		<guid isPermaLink="false">http://symptomadvice.com/overall-survival-benefit-with-velcade%c2%ae-based-therapy-in-previously-untreated-multiple-myeloma-patients-maintained-after-five-year-follow-up/</guid>
		<description><![CDATA[SAN DIEGO, Calif.&#8211;(BUSINESS WIRE)&#8211;Millennium: The Takeda Oncology Company with &#105;&#116;&#115; parent company Takeda Pharmaceutical Company Limited (TSE:4502) today reported results &#102;&#114;&#111;&#109; the final five-year follow-up analysis &#111;&#102; the international, multicenter, Phase III VISTA1 trial. The analysis assessed &#111;&#118;&#101;&#114;&#097;&#108;&#108; survival (OS) after treatment with VELCADE (bortezomib) in combination with melphalan and prednisone (VcMP) versus melphalan and [...]]]></description>
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<p>SAN DIEGO, Calif.&#8211;(BUSINESS WIRE)&#8211;Millennium: The Takeda Oncology Company with &#105;&#116;&#115; parent company Takeda Pharmaceutical Company Limited (TSE:4502) today reported results &#102;&#114;&#111;&#109; the final five-year follow-up analysis &#111;&#102; the international, multicenter, Phase III VISTA1 trial. The analysis assessed &#111;&#118;&#101;&#114;&#097;&#108;&#108; survival (OS) after treatment with VELCADE (bortezomib) in combination with melphalan and prednisone (VcMP) versus melphalan and prednisone (MP) alone, in patients with previously untreated multiple myeloma (MM) at &#097; median follow-up &#111;&#102; 60.1 months. The data &#119;&#101;&#114;&#101; presented by Professor Jesús F. San Miguel, M.D., Ph.D., Hospital Clìnico Universitario &#100;&#101; Salamanca, Salamanca, Spain, &#100;&#117;&#114;&#105;&#110;&#103; &#097;&#110; oral session at the 53rd annual meeting &#111;&#102; the American Society &#111;&#102; Hematology (ASH), held December 10-13, 2011 in San Diego, California. These long-term OS data &#119;&#101;&#114;&#101; &#097;&#108;&#115;&#111; the basis &#111;&#102; the recent FDA-approved label update for VELCADE. </p>
<p>&#8220;Elderly patients with multiple myeloma strive for upfront therapy that &#119;&#105;&#108;&#108; extend &#116;&#104;&#101;&#105;&#114; lives&#8221;</p>
<p> “This VELCADE-based therapy resulted in &#097;&#110; impressive 13.3-month increase in the median &#111;&#118;&#101;&#114;&#097;&#108;&#108; survival after five years &#111;&#102; follow-up,” &#115;&#097;&#105;&#100; San Miguel. “These data confirm that starting previously untreated multiple myeloma patients with the VELCADE based combination (VcMP) &#112;&#114;&#111;&#118;&#105;&#100;&#101;&#100; &#097; significant survival advantage over MP, &#097; recognized standard &#111;&#102; care, that &#099;&#111;&#117;&#108;&#100; &#110;&#111;&#116; be regained &#100;&#101;&#115;&#112;&#105;&#116;&#101; the substantial use &#111;&#102; novel agent based salvage therapies including VELCADE.” </p>
<p> The VISTA trial &#119;&#097;&#115; conducted in 682 previously untreated MM patients ineligible for high-dose therapy, and compared VcMP versus MP treatment alone. The primary endpoint &#111;&#102; the study &#119;&#097;&#115; time-to-disease progression, and secondary end points for the study &#119;&#101;&#114;&#101;: OS, progression free survival (PFS), response rates and safety. After &#097; median follow-up &#111;&#102; 60.1 months, median OS &#119;&#097;&#115; 56.4 versus 43.1 months for patients randomized &#116;&#111; VcMP and MP, &#114;&#101;&#115;&#112;&#101;&#099;&#116;&#105;&#118;&#101;&#108;&#121; – &#097; significant survival advantage &#111;&#102; 13.3 months for the VcMP arm (p=0.0004). &#097;&#110; exploratory analysis &#111;&#102; the incidence rate &#111;&#102; secondary primary malignancies (SPM) reported &#097;&#110; exposure-adjusted incidence rate &#111;&#102; 1.66 SPM &#112;&#101;&#114; 100-patient-years for VcMP, and 1.30 SPM for MP alone. </p>
<p> “Elderly patients with multiple myeloma strive for upfront therapy that &#119;&#105;&#108;&#108; extend &#116;&#104;&#101;&#105;&#114; lives,” &#115;&#097;&#105;&#100; Karen Ferrante, M.D., Chief Medical Officer, Millennium. “Today’s VELCADE data confirmed the sustained clinical benefits, including &#111;&#118;&#101;&#114;&#097;&#108;&#108; survival and complete response, that VELCADE &#112;&#114;&#111;&#118;&#105;&#100;&#101;&#100; in patients with previously untreated MM.” </p>
<p> <b>Continued &#111;&#118;&#101;&#114;&#097;&#108;&#108; Survival Benefit After 5 Years’ Follow-Up with Bortezomib-Melphalan-Prednisone (VcMP) Versus Melphalan-Prednisone (MP) in Patients with Previously Untreated Multiple Myeloma, and &#110;&#111; Increased Risk &#111;&#102; Second Primary Malignancies: Final Results &#111;&#102; the Phase 3 VISTA Trial (Abstract #476)</b> </p>
<p> The updated results &#115;&#104;&#111;&#119;&#101;&#100;: </p>
<ul>
<li> After &#097; median follow-up &#111;&#102; 60.1 months, median OS &#119;&#097;&#115; 56.4 months in the VcMP arm compared &#116;&#111; 43.1 months in the MP arm (HR 0.695, p=0.0004), reflecting &#097; 13.3-month OS advantage </li>
<li> &#097;&#109;&#111;&#110;&#103; patients who received subsequent therapies, OS &#119;&#097;&#115; significantly longer in patients who received VcMP upfront compared &#116;&#111; &#116;&#104;&#111;&#115;&#101; who received MP (median 55.7 vs. 46.4 months; HR 0.745, p=0.0162) </li>
<li> Time &#116;&#111; next treatment (median 27.0 vs. 19.2 months; HR 0.557, p&lt;0.0001) and treatment-free interval (median 16.6 vs. 8.3 months, HR 0.573, p&lt;0.0001) &#119;&#101;&#114;&#101; longer with VcMP versus MP </li>
<li> The exposure-adjusted incidence rate &#111;&#102; 1.66 SPM &#112;&#101;&#114; 100-patient-years for VcMP, and 1.30 SPM for MP alone </li>
</ul>
<p> Patients &#119;&#101;&#114;&#101; randomized (1:1) &#116;&#111; receive &#110;&#105;&#110;&#101; 6-week cycles &#111;&#102; VcMP (N=344; bortezomib 1.3 mg/m2, days 1, 4, 8, 11, 22, 25, 29, and 32, cycles 1–4, days 1, 8, 22, and 29, cycles 5–9; melphalan 9 mg/m2 days 1–4, prednisone 60 mg/m2, days 1–4, all cycles) &#111;&#114; MP (N=338) alone. Patients &#119;&#101;&#114;&#101; followed at least every 12 weeks for survival and subsequent therapy use. Data &#111;&#110; SPM &#119;&#101;&#114;&#101; collected by surveying all study sites &#116;&#111; capture information for 655 (96 percent) patients. </p>
<p> <b>Maintenance therapy with bortezomib plus thalidomide (VT) &#111;&#114; bortezomib plus prednisone (VP) after induction with bortezomib, melphalan and prednisone (VcMP) &#111;&#114; bortezomib, thalidomide and prednisone (VTP) in elderly untreated myeloma patients included in the GEM2005MAS65 Spanish randomized trial. (Abstract #477)</b> </p>
<p> This Phase III trial in 260 elderly patients, with &#097; median age &#111;&#102; 73 years, &#119;&#097;&#115; conducted by the Spanish Myeloma Group PETHEMA/GEM. The patients remained &#111;&#110; maintenance therapy for &#117;&#112; &#116;&#111; three years. &#111;&#110;&#101; &#116;&#104;&#105;&#114;&#100; &#111;&#102; the patients &#119;&#101;&#114;&#101; over the age &#111;&#102; 75. The updated results, presented by María-Victoria Mateos, M.D., Hospital Universitario &#100;&#101; Salamanca, Salamanca, Spain &#115;&#104;&#111;&#119;&#101;&#100;: </p>
<ul>
<li> Maintenance therapy with VT &#111;&#114; VP resulted in &#097;&#110; increase in immunofixation-negative complete response (CR) rates &#102;&#114;&#111;&#109; 24 percent after induction &#116;&#111; 42 percent, after &#097; median &#111;&#102; 20 months &#111;&#102; maintenance therapy </li>
<li> At &#097; median follow-up &#111;&#102; 46 months, median PFS &#119;&#097;&#115; 39 months for patients receiving VT maintenance and 32 months for patients receiving VP maintenance (p=0.1) </li>
<li> Median OS for the VP arm &#119;&#097;&#115; 60 months; median OS for the VT arm has &#110;&#111;&#116; &#121;&#101;&#116; been reached at &#097; median follow-up &#111;&#102; 46 months since &#102;&#105;&#114;&#115;&#116; randomization </li>
<li> Most common grade ?3 adverse events in the maintenance phase &#119;&#101;&#114;&#101;;
<ul>
<li> VT: Peripheral neuropathy (9 percent), GI symptoms (4 percent), asthenia and cardiac events (each 2 percent), neutropenia (1 percent) </li>
<li> VP: Peripheral neuropathy (3 percent), GI symptoms (0 percent), asthenia (0 percent), cardiac events (1 percent), neutropenia (0 percent) </li>
</ul>
</li>
</ul>
<p> Patients &#119;&#101;&#114;&#101; randomized &#116;&#111; receive &#115;&#105;&#120; cycles &#111;&#102; VMP &#111;&#114; VTP &#097;&#115; induction therapy followed by randomization &#116;&#111; maintenance. Maintenance therapy included VELCADE 1.3 mg/m2 &#111;&#110; day 1, 4, 8, 11 every three months for both arms, plus either thalidomide 50 mg daily for VT &#111;&#114; prednisone 50 mg every other day for VP for &#117;&#112; &#116;&#111; three years. </p>
<p> <b>About VELCADE</b> </p>
<p> VELCADE is co-developed by Millennium and Janssen Pharmaceutical Companies &#111;&#102; Johnson &amp; Johnson. Millennium is responsible for commercialization &#111;&#102; VELCADE in the U.S., Janssen Pharmaceutical Companies &#111;&#102; Johnson &amp; Johnson &#097;&#114;&#101; responsible for commercialization in Europe and the rest &#111;&#102; the world. Takeda Pharmaceutical Company Limited and Janssen Pharmaceutical K.K. co-promote VELCADE in Japan. VELCADE is approved in &#109;&#111;&#114;&#101; than 90 countries and has been used &#116;&#111; treat &#109;&#111;&#114;&#101; than 300,000 patients worldwide. </p>
<p> <i><b>Important Safety Information</b></i> </p>
<p> VELCADE® (bortezomib) is approved for the treatment &#111;&#102; patients with multiple myeloma. VELCADE is &#097;&#108;&#115;&#111; approved for the treatment &#111;&#102; patients with mantle cell lymphoma who have already received at least &#111;&#110;&#101; prior treatment. </p>
<p> Patients &#115;&#104;&#111;&#117;&#108;&#100; &#110;&#111;&#116; receive VELCADE &#105;&#102; they &#097;&#114;&#101; allergic &#116;&#111; bortezomib, boron &#111;&#114; mannitol. Women &#115;&#104;&#111;&#117;&#108;&#100; be advised &#110;&#111;&#116; &#116;&#111; &#116;&#097;&#107;&#101; VELCADE &#119;&#104;&#105;&#108;&#101; pregnant &#111;&#114; breast-feeding. Patients with diabetes may require close monitoring and adjustment &#111;&#102; &#116;&#104;&#101;&#105;&#114; medication. </p>
<p> VELCADE can cause &#115;&#101;&#114;&#105;&#111;&#117;&#115; side effects, including: </p>
<ul>
<li> Lowering the levels &#111;&#102; blood cells, which &#099;&#111;&#117;&#108;&#100; result in &#097; higher risk for infections &#111;&#114; bleeding. </li>
<li> Nausea, vomiting, diarrhea and constipation. </li>
<li> Nerve problems, which can be severe including muscle weakness, tingling, burning, pain, &#111;&#114; loss &#111;&#102; feeling in the hands and feet. </li>
<li> &#097; drop in blood pressure resulting in dizziness, light headedness &#111;&#114; fainting. </li>
<li> Heart rhythm problems and heart failure including worsening &#111;&#102; existing conditions. Symptoms may include chest pressure &#111;&#114; pain, palpitations, swelling &#111;&#102; the ankles &#111;&#114; feet, &#111;&#114; shortness &#111;&#102; breath. </li>
<li> Lung disorders, some &#111;&#102; which have been fatal. Symptoms include cough, shortness &#111;&#102; breath, wheezing &#111;&#114; difficulty breathing. </li>
<li> Liver failure including &#097; yellow discoloration &#111;&#102; the eyes and skin. </li>
<li> Tumor Lysis Syndrome and Reversible Posterior Leukoencephalopathy Syndrome have been reported. </li>
</ul>
<p> Common side effects seen in patients receiving VELCADE include: fever, decreased appetite, fatigue, insomnia and headache. </p>
<p> Additional information and full prescribing information is available at VELCADE.com. </p>
<p> Please &#115;&#101;&#101; the full prescribing information for VELCADE including warnings and precautions. </p>
<p> For &#109;&#111;&#114;&#101; information about VELCADE clinical trials, patients and physicians can contact the Millennium Medical Product Information Department at 1-866-VELCADE (1-866-835-2233). </p>
<p> Editor’s Note: This press release is &#097;&#108;&#115;&#111; available &#117;&#110;&#100;&#101;&#114; the Media section &#111;&#102; the Company’s website at: millennium.com/InTheNews.aspx. </p>
<p> <b>About Millennium</b> </p>
<p> Millennium: The Takeda Oncology Company, &#097; leading biopharmaceutical company based in Cambridge, Mass., markets VELCADE, &#097; first-in-class proteasome inhibitor, and has &#097; robust clinical development pipeline &#111;&#102; product candidates. Millennium Pharmaceuticals, &#105;&#110;&#099;. &#119;&#097;&#115; &#097;&#099;&#113;&#117;&#105;&#114;&#101;&#100; by Takeda Pharmaceutical Company &#108;&#116;&#100;. in May, 2008. The Company’s research, development and commercialization activities &#097;&#114;&#101; focused in oncology. Additional information about Millennium is available through &#105;&#116;&#115; website, millennium.com. </p>
<p> <b>About Takeda</b> </p>
<p> Located in Osaka, Japan, Takeda is &#097; research-based global company with &#105;&#116;&#115; main focus &#111;&#110; pharmaceuticals. &#097;&#115; the &#108;&#097;&#114;&#103;&#101;&#115;&#116; pharmaceutical company in Japan and &#111;&#110;&#101; &#111;&#102; the global leaders &#111;&#102; the industry, Takeda is committed &#116;&#111; strive towards &#098;&#101;&#116;&#116;&#101;&#114; health for patients worldwide through leading innovation in medicine. Additional information about Takeda is available through &#105;&#116;&#115; corporate website, takeda.com. </p>
<p> 1 (<b>V</b>ELCADE &#097;&#115; <b>I</b>nitial <b>S</b>tandard <b>T</b>herapy in Multiple Myelom<b>a</b>) </p>
<p> Photos/Multimedia Gallery Available: businesswire.com/cgi-bin/mmg.cgi?eid=50102746&amp;lang=en </p></p>
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