A recent study led by Professor Gareth Morgan, Professor of Haematology at The Institute of Cancer Research (ICR) and The Royal Marsden NHS Foundation Trust found that adding a second drug to standard chemotherapy treatment can help patients diagnosed with this aggressive type of bone marrow cancer live longer.
The term myeloma is used to describe particular types of white blood cells called plasma cells when they behave abnormally due to certain genetic mutations. Plasma cells are produced by the body to fight off infections and normally die once the infection has been eliminated. Abnormal plasma cells continue to divide, rather than die, until they form a mass of abnormal cells – a tumour. As plasma cells are produced by the bone marrow, myelomas develop in the bone. When there are several of these myeloma tumours present in a single person, the term multiple myeloma is used.
Myeloma cells cause the resorption of bone faster than it can be produced, which can cause weak bones, resulting in complications such as fractures, lesions and spinal compression in myeloma patients. Bisphosphonates are approved in the UK for multiple myeloma patients to reduce bone complications associated with the cancer.
The Myeloma IX Study
The Medical Research Council Myeloma IX study led by Professor Gareth Morgan compared the two bisphosphonate drugs, zoledronic acid and clondronic acid. The results of the 1960 patient study showed that treatment with zoledronic acid extends the lives of multiple myeloma patients by an average 5.5 months longer than treatment with clondronic acid. This anticancer effect is independent of its effect on bone complications.
Additionally, patients in the zoledronic acid group were 16% less likely than those on clondronic acid to succumb to the disease during the average 3.7 years they took part in the study and subsequent follow-up. Zoledronic acid also reduced the development of new bone lesions by 24% compared to clondronic acid.
Professor Morgan has said: “Our study provides strong evidence that zoledronic acid should become part of the new gold standard care.”
Though both are bisphosphonates, zoledronic acid and clodronic acid differ in terms of their structure and the mode of action they have within the body. One main difference is that Zoledronic acid contains nitrogen, which may be significant in its survival benefit.
More than 3.5 million patients worldwide have already been given zoledronic acid to treat bone complications. The ICR and The Royal Marsden led study provides evidence that zoledronic acid should also be administered to newly diagnosed multiple myeloma patients for its anticancer properties, and increased survival rates for patients.