Researchers from Germany have reported that a short three-day course of Kepivance® (palifermin) reduces toxicity of high-dose therapy (HDT) and autologous stem cell transplantation (ASCT) in patients with multiple myeloma. The details of this study were published early online in the Annals of Oncology on March 16, 2010.[1]

Kepivance, keratinocyte growth factor, is approve by the U.S. food and drug administration for prevention of chemotherapy-induced oral mucositis in patients receiving chemotherapy and in patients receiving HDT and ASCT.

The current Phase II study involved 67 patients with multiple myeloma receiving high-dose melphalan followed by ASCT. All patients received palifermin for three days before HDT. Neulasta® (pegfilgrastim) was administered after stem cell infusion. Results were compared to previous patients, who were supported with Neulasta alone without Kepivance or without both Neulasta and Kepivance. In patients receiving Kepivance, there was more severe mucositis among those with renal failure than in patients with normal renal function. They compared patients with normal renal function receiving or not receiving Kepivance. These authors reported that patients receiving Kepivance had significantly fewer days of hospitalization, less parenteral nutrition, lower narcotic use, and fewer red blood cell transfusions compared with historical control patients. Time to hematopoietic recovery was “not compromised by the use of palifermin.” These authors suggest that Kepivance was an effective supportive care agent but was not effective in patients with poor renal function.

Comments: This study further documents the effectiveness of Kepivance in preventing oral mucositis in the stem cell transplant setting.

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