Patients with relapse multiple myeloma may have an improved survival rate with a new drug combination, according to findings from a recent clinical study that is believed to be one of the largest multi-centre trials conducted in Asia, with centres located in Japan, Taiwan as well as in Singapore, among other locations.

The trial was led by Professor Chng Wee Joo from the National University Cancer Institute, Singapore (NCIS) and conducted by the Asian Myeloma Network, which establishes low-cost novel therapies that are relevant to patients in the Asian community by bringing in clinical trials to patients in the region.

"With such trials, patients can get access to these drugs for free. Over the longer term, we hope to contribute towards making such drugs more accessible to patients who need them,” said Chng.

Trial shows promising results on survival rates

A total of 136 patients with relapse multiple myeloma participated in the trial, of whom 24 were from Singapore. Participants were considered to have “end stage” cancers who did not respond well to an average of four rounds of standard therapy.

The clinical trial, AMN 0001, examined a new drug combination of Dexamethasone and an immunomodulatory drug, Pomalidomide in the participants. Patients with suboptimal response to the new combination after three cycles of treatment in the trial were also given another chemotherapy drug, cyclophosphamide.

The results achieved were promising – approximately 50% of the patients lived for at least 14 months, which is more than double the expected survival rate of patients with multiple myeloma. Roughly 10% of participants also achieved near remission.

Participants also reported mild side effects of low blood count and rashes.

Raising profiles of Asian community in multiple myeloma research

Though the incidence of multiple myeloma is a rare in Singapore, with 120 new cases reported annually, the incidence has been increasing by 10% to 15% over the past several years.

There is no known cure for multiple myeloma to date, however, six new drugs have shown promising effects for treatment of multiple myeloma in the West over the past five years. Unfortunately, novel drugs are expensive and take a longer time before they are approved for use in Asian countries. Pomalidomide, for example, will cost a patient approximately $10,000 a month.

The Asian Myeloma Network aims to raise profiles of the Asian community in the field of research and treatment for patients with multiple myeloma. The NCIS hopes to conduct three other clinical trials through the Asian Myeloma Network by the end of 2017.

"I was going nowhere, so I thought there's no point wasting time on chemotherapy since it wasn't working,” said Mr Edmund Tai, a 68 year old gentleman who was diagnosed with multiple myeloma in June 2013 and participated in the trial. Tai had previously undergone various treatments for his cancer including 10 cycles of chemotherapy at Tan Tock Seng Hospital.

He did not respond well to them, but is now receiving treatment at NCIS. MIMS

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