NCCN Updates Multiple Myeloma Guidelines
JENKINTOWN, Pa., October 23, 2007 — The National Comprehensive Cancer Network (NCCN) announces important updates to the NCCN Multiple Myeloma Guidelines. The NCCN Clinical Practice Guidelines in Oncology™ are widely recognized and applied as the standard of care in oncology in the United States in both the community and the academic practice settings.
The NCCN Multiple Myeloma Guidelines now include bortezomib (Velcade®, Millennium Pharmaceuticals)in combination with pegylated liposomal doxorubicin (Doxil®, Ortho Biotech) as a category 1 recommendation for patients with relapsed/refractory multiple myeloma in the following clinical situations:
- Patients with progressive disease following allogeneic or autologous stem cell transplant (SCT)
- Patients with primary progressive disease following initial autologous or allogeneic SCT
- Non transplant candidates with progressive or relapsing disease after initial induction therapy.
This recommendation is based on the recent FDA approval for combining bortezomib with pegylated liposomal doxorubicin injection for the treatment of multiple myeloma in patients who have not previously received bortezomib and have received at least one prior therapy. The FDA approval was based on a priority review of interim data from an international phase III trial, showing that use of the drug combination significantly extended the median time to disease progression from 6.5 months for bortezomib to 9.3 months with the pegylated liposomal doxorubicin and bortezomib combination.
At the 2007 ASCO annual meeting, an updated survival analysis of the study was presented with a median follow-up of 11 month. Median duration of response was increased from 7.0 months to 10.2 months with the combination therapy. Updated overall survival (OS) analysis showed pegylated liposomal doxorubicin plus bortezomib significantly improved OS.
Although bortezomib monotherapy is also a category 1 recommendation, liposomal doxorubicin with bortezomib is preferred to bortezomib monotherapy for the treatment of patients with relapsed/refractory multiple myeloma.
Other treatment regimens added during the 2008 update process include DCEP (dexamethasone, cyclophosphamide [Cytoxan®, Bristol-Myers Squibb], etoposide [(Toposar®, Pfizer and VePesid®, Bristol-Myers Squibb], and cisplatin) regimen to the list of salvage therapy regimens and bortezomib/thalidomide/dexamethasone regimen to the list of primary induction regimen for transplant candidates.
NCCN Clinical Practice Guidelines in Oncology™ are developed and continually updated through an evidence-based process with explicit review of the scientific evidence by multidisciplinary panels of expert physicians from NCCN Member Institutions. The most recent version of this and all the guidelines are available free of charge at www.nccn.org.
About the National Comprehensive Cancer Network
The National Comprehensive Cancer Network® (NCCN®), a not-for-profit alliance of 27 of the world's leading cancer centers, is dedicated to improving the quality and effectiveness of care provided to patients with cancer. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers. The primary goal of all NCCN initiatives is to improve the quality, effectiveness, and efficiency of oncology practice so patients can live better lives. For more information, visit NCCN.org.
The NCCN Member Institutions are:
- Fred & Pamela Buffett Cancer Center
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
- City of Hope Comprehensive Cancer Center
- Dana-Farber/Brigham and Women's Cancer Center | Massachusetts General Hospital Cancer Center
- Duke Cancer Institute
- Fox Chase Cancer Center
- Huntsman Cancer Institute at the University of Utah
- Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
- Mayo Clinic Cancer Center
- Memorial Sloan Kettering Cancer Center
- Moffitt Cancer Center
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
- Roswell Park Cancer Institute
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
- St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
- Stanford Cancer Institute
- University of Alabama at Birmingham Comprehensive Cancer Center
- UC San Diego Moores Cancer Center
- UCSF Helen Diller Family Comprehensive Cancer Center
- University of Colorado Cancer Center
- University of Michigan Comprehensive Cancer Center
- The University of Texas MD Anderson Cancer Center
- University of Wisconsin Carbone Cancer Center
- Vanderbilt-Ingram Cancer Center
- Yale Cancer Center/Smilow Cancer Hospital