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Biopharmaceuticals Oncology

 News Release - October 23, 2007

NCCN Updates Multiple Myeloma Guidelines

JENKINTOWN, Pa.--(HSMN NewsFeed)--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

About the National Comprehensive Cancer Network

The National Comprehensive Cancer Network (NCCN), a not-for-profit alliance of 21 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.

The NCCN Member Institutions are: City of Hope, Los Angeles, CA; Dana-Farber/Brigham and Women’s Cancer Center | Massachusetts General Hospital Cancer Center, Boston, MA; Duke Comprehensive Cancer Center, Durham, NC; Fox Chase Cancer Center, Philadelphia, PA; Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT; Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, WA; Arthur G. James Cancer Hospital & Richard J. Solove Research Institute at The Ohio State University, Columbus, OH; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL; Memorial Sloan-Kettering Cancer Center, New York, NY; H. Lee Moffitt Cancer Center & Research Institute at the University of South Florida, Tampa, FL; Roswell Park Cancer Institute, Buffalo, NY; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO; St. Jude Children’s Research Hospital/University of Tennessee Cancer Institute, Memphis, TN; Stanford Comprehensive Cancer Center, Stanford, CA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL; UCSF Comprehensive Cancer Center, San Francisco, CA; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; UNMC Eppley Cancer Center at The Nebraska Medical Center, Omaha, NE; The University of Texas M. D. Anderson Cancer Center, Houston, TX; and Vanderbilt-Ingram Cancer Center, Nashville, TN.

For more information, visit

Source: National Comprehensive Cancer Network

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