Pilot study of recombinant human soluble tumor necrosis factor (TNF) receptor (p75) fusion protein (TNFR:Fc; Enbrel) in patients with refractory multiple myeloma:: increase in plasma TNFα levels during treatment

Elevated tumor necrosis factor (TNF)-alpha levels are associated with poor prognosis in patients with multiple myeloma (MM). Enbrel is a TNF antagonist fusion protein consisting of the extracellular, ligand-binding domain of the human p75 TNF receptor linked to the Fc portion of human IgG1. Ten patients with refractory MM were treated with Enbrel 25 mg s.c twice weekly for a minimum of eight median age was 63 years (range, 43-76). The total number of Enbrel doses was 191 (median 16; range, 3-55). TNFalpha plasma levels increased significantly during treatment with Enbrel. No objective response occurred. Acceleration of disease occurred in four patients. While well-tolerated, Enbrel did not have anti-myeloma activity as administered on this study. (C) 2002 Elsevier Science Ltd. All rights reserved.