According to Celgene's market research, 15% of MDS patients are treated with either Revlimid or Vidaza.
Now on the market for treating that rarer cancer, Revlimid costs twice as much as thalidomide.
First, it appears that patients on Revlimid lived longer, although that result is not statistically significant.
Additionally, a combination clinical study of TG-1101 with Revlimid will be started in the fourth quarter of 2012.
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Researchers at the Dana-Farber Cancer Institute in Boston took Celgene's improved version, Revlimid, and rushed it into myeloma trials.
Velcade, approved in 2003, and Revlimid, a thalidomide successor approved in 2006, are now backbones of myeloma treatment, doctors say.
The risk turned up in two studies, both of which gave Revlimid to patients long-term after they had received bone marrow transplants.
Within the next six months Celgene will likely win approval to market both Thalomid and Revlimid as treatments for multiple myeloma.
In 77 of the 148 patients in a small trial, Revlimid seemed to make all signs of the disease disappear entirely.
Revlimid, Celgene's second biggest-selling drug, is basically an improved version of Thalomid.
The study tested whether myeloma patients who had stable disease following a bone marrow transplant did better if they received Revlimid or placebo.
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Revlimid is the chemical cousin and heir to Celgene's first drug, Thalomid, which is still probably better known by its generic name, thalidomide.
She said until a final decision was made by NICE, there was no reason why clinicians should not continue to prescribe Revlimid where appropriate.
Despite the new approvals, doctors like David Siegel still plan on typically starting patients with a combination of Velcade, Revlimid and a steroid called dexamethasone.
That is not an issue with Revlimid, Celgene says, and many doctors believe that won't be as much of an issue with Kyprolis and Pomalyst.
Celgene, instead, found by accident that thalidomide, the nausea drug that causes birth defects, was a potent cancer fighter and developed an improved follow-on version, Revlimid.
Richardson points out that Thalomid, Celgene's follow-up drug Revlimid and Velcade, from Millennium Pharmaceuticals (nasdaq: MLNM - news - people ) of Cambridge, Mass.
Revlimid extends the time patients live without cancer worsening, and this means that there was a lot more time in the myeloma groups for cancer to show up.
It played a key role in the development of Velcade and Revlimid, two of the biggest advances in treating the disease, which is diagnosed in 20, 000 patients a year.
The health watchdog, which sets the agenda for funding new treatments in England and Wales, will consult on Revlimid over the next three weeks before making its final recommendation in January.
After five years of arduous synthesis and testing, Stirling's researchers came up with their first promising tweak of thalidomide, Revlimid, by moving one oxygen atom and adding a bit of ammonia.
Shares in Celgene, the maker of the cancer treatments, fell 9% this morning on worries that long-term use of its Revlimid for multiple myeloma treatment might increase the risk of new tumors developing.
Eight percent more of those who were assigned to the Revlimid group were alive at the end of 28 months, even though many of the placebo patients switched to Revlimid when their disease got worse.
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Revlimid may not cause birth defects, but the FDA wants further data before freeing it from the tight restrictions that keep Thalomid from being used in women who are pregnant or who could become pregnant.
Patients who got Revlimid still lived longer.
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Although full results are not known, Celgene announced in its second-quarter earnings release Thursday that the study had been stopped ahead of schedule because the difference between patients getting Revlimid and those on a control group was already apparent.
In December Celgene won approval for its second drug, Revlimid, the product of a 13-year quest to develop a version of thalidomide that would be as potent against cancer but would lack most of the old drug's side effects, such as nerve damage and fatigue.
Revlimid, a treatment for bone marrow cancer, was a good example (and there are others) where manufacturers have shown flexibility in pricing in the UK, despite the fact that the same medicines are widely available to patients elsewhere in Europe and often at higher prices.
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