01 March 18 The Straits Times by CHERYL TEE
A drug which aims to increase the length of time myeloma patients can spend without the disease getting worse has been approved by the Health Sciences Authority.
Myeloma is an almost incurable blood cancer in the bone marrow or soft tissue. Symptoms include bone pain, kidney failure and anaemia.
Relapses are common due to the disease rarely reaching complete remission. Once diagnosed, patients generally live another eight to 10 years.
The drug, called carfilzomib, when combined with existing drugs, has boosted progression-free survival - the length of time during and after treatment when the disease does not get worse - from nine months to 18.7 months.
Its effects were uncovered through an international clinical trial from 2012 to 2014 that involved 929 patients from 27 countries, of which 20 were Singaporean.
In Singapore, four in 10 myeloma patients had at least one relapse, according to a study by the National University Cancer Institute, Singapore (NCIS) between 2009 and last year. Of the 143 patients in the study, 56 had one relapse, 21 had two relapses and nine had three relapses.
"There are some myeloma patients - less than 10 per cent - that, with some of these treatments, have no disease at all for more than 10 years. They may well be cured. But this is rare," said Professor Chng Wee Joo, director of the NCIS.
Existing treatments also become less effective with each relapse due to disease resistance and biology.
This means that a patient ends up paying more for treatments if he faces multiple relapses. The same study by NCIS found that patients with a second, third and fourth relapse will spend over $400, $800 and $2,000 respectively per week on average.
"It's almost like evolution - the tumour cells which can survive the harsh environments are more robust," said Prof Chng.
Given the body's resistance to traditional drugs, he described carfilzomib's potency as "impressive".
The approval of the drug is also a timely one, noted the NCIS, given the spike in new myeloma cases here. Last year, 39 patients were diagnosed with the disease by the NCIS compared with 22 cases in 2012 - an 80 per cent increase.
The NCIS said the spike in new cases was due to an ageing population and better myeloma awareness among doctors.
It is currently conducting a trial with carfilzomib and two other drugs to provide a cheaper and more effective alternative to the current stable of myeloma treatments.
Each vial of carfilzomib costs about $1,100 for subsidised patients and $2,200 for private patients at public and private hospitals. Prices also differ according to a patient's height and weight, and the dosage needed.