Velcade for Waldenstrom’s – pro

Waldenström’s macroglobulinemia (WM) is a CD20 expressing B-cell malignancy represented by the pathological diagnosis of IgM secreting lymphoplasmacytic lymphoma.

Chen, et al. (2007) found bortezomib to be an active agent in Waldenstrom’s macroglobulinemia but it was an uncontrolled phase II clinical trial in which untreated or previously treateds ymptomatic patients with Waldenstrom’s macroglobulnemia (n = 27) received bortezomib on a 21-day cycle until two cycles .

Treon, et al. (2007) reported on an uncontrolled clinical study which found bortezomib to be an active agent in relapsed and refractory Waldenstrom’s macroglobulinemia. The overall response rate was 85%, with 10 and 13 patients achieving minor and major responses, respectively. The investigators observed that sensory neuropathies resolved or improved in nearly all patients following cessation of therapy.

Guidelines from the National Comprehensive Cancer Network (p. WLMPL-B, 2011) indicates bortezomib with rituximab ”particularly” for primary treatment of symptomatic hyperviscosity in Waldenstrom’s macroglobulinemia. However, NCCN appears to accept the combination with Rituxan without hyperviscosity also.

Velcade is currenlty under a French study for this diagnosis: Efficacy of Bortezomib (Velcade(R)) in Patients With Advanced Waldenström Macroglobulinemia (WM2), NCT00777738. This trial is designed to evaluate the efficacy and toxicity in patients with advanced Waldenström’s Macroglobulinemia disease. A Belgian study, NCT00142129, was completed in 2007 and not yet published.

A. Vijay and M. A. Gertz
Waldenstrom macroglobulinemia
Blood, June 15, 2007; 109(12): 5096 – 5103.

Johnson SA, Birchall J, Luckie C, Oscier DG, Owen RG, Haemato-Oncology Task Force of the British Committee for Standards in Haematology. Guidelines on the management of Waldenstrom macroglobulinaemia. Br J Haematol 2006 Mar;132(6):683-97. [108 references]

Chen CI, Kouroukis CT, White D, et al; National Cancer Institute of Canada Clinical Trials Group. Bortezomib is active in patients with untreated or relapsed Waldenstrom’s macroglobulinemia: A phase II study of the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol. 2007;25(12):1570-1575.

Treon SP, Hunter ZR, Matous J, et al. Multicenter clinical trial of bortezomib in relapsed/refractory Waldenstrom’s macroglobulinemia: Results of WMCTG Trial 03-248. Clin Cancer Res. 2007;13(11):3320-3325.

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