Efficacy of low-dose thalidomide and dexamethasone as first salvage regimen in multiple myeloma

Abstract

As first salvage regimen, THAL-DEX was superior to CC, as second or third salvage regimen, it was equivalent to CC. THAL-DEX is not myelotoxic. It postpones the delivery of effective salvage chemotherapy. This might explain the survival benefit.

Maintenance thalidomide following single cycle autologous peripheral blood stem cell transplant in patients with multiple myeloma

“…Furthermore, durable responses with low-dose thalidomide, as low as 50-100 mg a day, have also been reported. 14,15 Our results also suggest that the potential benefit of thalidomide might be influenced by the underlying biological parameters such as presence of chromosome 13 abnormality. Because of the design of our study to start thalidomide early post transplant in a state of minimal residual disease, it is difficult to address the contribution of thalidomide to complete remission rate and it is also possible that our results could be related to delayed response from transplant.…”

Single-agent thalidomide for treatment of first relapse following high-dose chemotherapy in patients with multiple myeloma

“…Interestingly, the cumulative dose of thalidomide within the first 3 months of treatment was not predictive for response or outcome in our study. Some authors have suggested before that there is no dose-response relationship with thalidomide, 9,10 which is in contrast to others [4][5][6] who showed that patients with a cumulative dosage of more than 32 or 42 g had a superior outcome. Patients in our study received a maximum of 32 g thalidomide within the first 3 months, and a cutoff level of 18 g was used for analysis.…”

Recent clinical studies of the immunomodulatory drug (IMiD®) lenalidomide

“…Thalidomide combined with dexamethasone in relapsed, refractory MM induces a partial response in 56% of patients (Palumbo et al, 2004a). In newly diagnosed patients, thalidomide and dexamethasone therapy resulted in 64% partial responses (Rajkumar et al, 2002).…”