A clinical trial led by the University of Leeds has demonstrated that an innovative treatment regimen for relapsed myeloma patients could extend disease-free periods by an average of seven months compared to standard care.
The UK Myeloma Research Alliance Myeloma XII (ACCoRd) trial, published in the Lancet Haematology, tested a protocol combining a second autologous stem cell transplant with targeted drug therapy as an alternative to conventional chemotherapy approaches.
Myeloma, which accounts for approximately 1 in 50 new cancer diagnoses in the UK, is a blood cancer typically characterized by recurring relapses throughout a patient's life. While initial treatment with stem cell transplants from a patient's own bone marrow can lead to remission, the disease invariably returns.
Novel Treatment Approach Shows Promising Results
The trial investigated a treatment protocol where patients who had experienced myeloma relapse underwent a second stem cell transplant using cells from their own bone marrow. Following the transplant, patients received a combination of thalidomide, dexamethasone, and ixazomib to suppress cancerous cells, with ixazomib continuing as a maintenance therapy.
Professor Gordon Cook, who led the trial and serves as Professor of Haematology and Director of the Leeds Cancer Research Centre, explained the significance of the findings: "Not only did the ACCoRd trial improve patients' time free from myeloma, it showed that using these drugs can also improve patients' quality of life compared to using chemotherapy or long-term steroid use."
The treatment resulted in extended disease-free survival by seven months compared with regular treatment approaches.
Mechanism of Action
Ixazomib represents a targeted approach to treating myeloma. The drug works by inhibiting the breakdown of damaged or unwanted proteins within cells. Since myeloma cells produce higher amounts of proteins than non-cancerous cells, this mechanism causes a toxic buildup specifically in cancer cells while allowing healthy cells to grow.
An additional benefit of ixazomib is that it is not a steroid, potentially reducing treatment-associated complications related to metabolism and infections that are common with other therapies.
Widespread Clinical Trial
The ACCoRd trial was conducted across 79 UK hospitals and received funding from Stand Up To Cancer, Cancer Research UK, and Takeda Oncology, with Takeda also providing the study drug ixazomib.
Dr. Nisharnthi Duggan, Science Engagement Manager at Cancer Research UK, commented on the findings: "It's great that initial results of the ACCoRd trial show that people who received targeted treatment after their stem cell transplant had more time with their loved ones. We're pleased to fund this study investigating potential new treatment options for people with myeloma through our Stand Up To Cancer campaign."
Professor John Snowden, co-author of the study and Honorary Consultant Haematologist at Sheffield Teaching Hospitals NHS Foundation Trust, highlighted the collaborative nature of the research: "It was very special that Sheffield Teaching Hospitals were able to make a major contribution to the recruitment and completion of this important clinical trial, which confirmed benefits for patients with relapsed myeloma by providing them with significantly improved length of remission."
Clinical Implications
The researchers emphasize that the results present an alternative treatment option specifically for patients who are well enough to undergo a second bone marrow transplant. This approach adds to the growing arsenal of treatments for myeloma, a disease that remains incurable but increasingly manageable with modern therapeutic approaches.
The trial was managed by the Cancer Research UK Clinical Trials Research Unit Leeds and sponsored by the University of Leeds, with additional support from the National Institute of Health and Care Research through the NIHR Leeds Biomedical Research Centre.
As the final analysis of the trial data continues, the medical community anticipates further insights into the long-term benefits and optimal application of this treatment protocol for patients with relapsed myeloma.
