Pharmacy Professors Phelps, Poi Receive Pelotonia Award to Develop Autologous Dosing Algorithm for Multiple Myeloma

Daniel Helfand
Professor Phelps
07/08/2014

The Ohio State University Comprehensive Cancer Center and Arthur G. James Cancer Hospital has granted a $100,000 Pelotonia Award to College of Pharmacy faculty members Mitch Phelps and Ming Poi. The grant will be used to augment existing therapies used to treat multiple myeloma (MM), a bone marrow cancer that more than 20,000 Americans are diagnosed with each year, according to the National Cancer Institute. Craig Hofmeister and Susan Geyer of the Wexner Medical Center are also principal investigators on the project. 

The research will use preliminary data that has been collected from 140 MM patients who had undergone autologous stem cell transplantation treatment. This treatment features a process where the patient has stem cells removed from his or her body and clinicians then give a dose of melphalan, a drug used in the treatment of MM, to kill cancer cells. After the drug treatment, the stem cells are reintroduced to the patient’s body.

The research team for this project aims to identify biomarkers that can help identify whether this therapy would be effective for specific patients while also developing a personalized medicine strategy for individual patients based off these biomarkers.  

“There isn’t a one size fits all model for this type of treatment,” said Phelps. “Some patients will be more sensitive to melphalan while others will have very little sensitivity to the drug. It’s key to identify biomarkers that we can use to properly dose patients during the treatment process in order to best prevent different kinds of toxicity, harmful side effects of melphalan.”

Harmful toxicities from the drug that can occur after treatment can be mucositis, a toxicity that breaks down the cells lining the gastro-intestinal tract; kidney malfunction; and other blood chemistry disorders. A dosing algorithm for patients could allow clinicians to give larger or smaller doses of melphalan based on a patient’s level of sensitivity to better kill cancer cells while preventing harmful side effects.

“Approximately 5,000 autologous transplants are performed annually in the United States, and all patients receive the same 200 mg/m2 dose of melphalan,” said Poi. “While highly effective, the high dose treatment comes with significant side effects. The ability to personalize the melphalan dose is especially important for elderly multiple myeloma patients who tend to experience more severe side effects, and this will hopefully allow more elderly MM patients access to the treatment.”

After development of the algorithm, the team hopes to conduct a randomized validation clinical trial, where they would compare their dosing algorithm versus standard dosing practices. If the results suggest the new dosing algorithm produced better results, it could supplant current practices and lead to more personalized care in the process.

“Autologous stem cell transplantation treatment is currently producing the best results for patients to overcome MM,” said Phelps. “We need this treatment to be as efficient as possible to produce the best results for MM patients undergoing this procedure.”