A trial looking at an antibiotic to try to prevent infections in people having treatment for myeloma (TEAMM)

Cancer type:

Blood cancers

Myeloma

Status:

Results

Phase:

Phase 3

This trial looked at an antibiotic called levofloxacin to see if it reduced the risk of infection and death in people starting treatment for myeloma.

More about this trial

Myeloma is a type of cancer that develops from cells in the bone marrow Open a glossary item called plasma cells. Plasma cells are part of the immune system.

Because myeloma affects the immune system, people who have it are at a greater risk of picking up infections. This infection risk is much higher when the myeloma is active and you start treatment.

Researchers in this trial looked at reducing the risk of infection from the start. Rather than waiting to see if an infection developed and then treat it.

They tested an antibiotic Open a glossary item already used all over the world, called levofloxacin.

In this trial half of the people taking part took levofloxacin for 12 weeks when they started treatment for myeloma and the other half took a dummy tablet (placebo Open a glossary item ).

The aim of this trial was to see if taking levofloxacin at the start of treatment reduced the risk of infection.

Summary of results

The trial team found that taking levofloxacin at the start of treatment did reduce the risk of infection for people with newly diagnosed myeloma.

This trial closed in 2016 and these results were presented in 2017.

About this trial

This was an international phase 3 trial. It was a randomised trial. The 977 people who took part were put into 1 of 2 groups.

Neither they or their doctors knew which group they were in.

489 people had levofloxacin
488 people had a dummy drug (placebo )

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People were able to continue taking other anti infection medication, such as sulfamethoxazole-trimethoprim (SMZ-TMP) that was part of their routine care.

Results

Everyone took levofloxacin or a dummy drug for 12 weeks at the start of their myeloma treatment.

After the 12 weeks researchers then looked at how many people in each group had:

a high temperature
died
a high temperature and died

They found that having levofloxacin reduced the risk of both having a high temperature and dying.

The total number of people who had a high temperature and died was:

95 of the 489 people (19%) who had levofloxacin
134 of the 488 people (27%) who had the dummy drug

12 weeks after treatment the team looked at how many infections were reported in each group. They found that the total number of infections reported was 586. In the levofloxacin group there were 257 infections (44%) reported. In the dummy drug group there were 329 infections (56%) reported.

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315 people were also taking sulfamethoxazole-trimethoprim (SMZ-TMP) to prevent infection. Researchers said that having SMZ-TMP in addition to levofloxacin had helped reduce the number of high temperatures and deaths.

Conclusion
The team concluded that taking levofloxacin for 12 weeks at the start of treatment for myeloma can help prevent high temperatures and deaths.

The team recommend that future trials look at the value of adding SMZ-TMP to levofloxacin for more than 12 weeks.

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) but may not have been published in a medical journal. The figures we quote above were provided by the research team. We have not analysed the data ourselves.