Melphalan, prednisone, thalidomide and defibrotide in relapsed/refractory multiple myeloma: results of a multicenter phase I/II trial

Treatment of relapsed and refractory multiple myeloma

“…59,60 The efficacy is further improved when thalidomide is used in triple or even quadruple combinations, including thalidomide with dexamethasone and bortezomib (VTD), dexamethasone and cyclophosphamide (CTD), bortezomib plus melphalan and prednisone (VMPT) or dexamethasone (VMDT), lenalidomide, melphalan and prednisone (RMPT), or VTD with pegylated liposomal doxorubicin. 23,[61][62][63][64][65][66] These regimens have been associated with an ORR of 63-90% with CR being reported in 2-35% of patients.…”

Aspirin or enoxaparin thromboprophylaxis for patients with newly diagnosed multiple myeloma treated with lenalidomide

“…In a phase 1/2 study, only 1 VTE event was detected with defibrotide in combination with melphalan, prednisone, and thalidomide, in patients with relapsed/refractory MM without further thromboprophylaxis. 27 Defibrotide exerts a spectrum of pleiotropic effects on endothelium, hemostasis, and stroma, which makes it a potential protective agent against thromboembolism.…”

Targeting heparanase for cancer therapy at the tumor–matrix interface

“…Another drug being explored clinically is defibrotide, a polydisperse oligonucleotide isolated from porcine mucosa that has multiple biological effects including inhibition of heparanase expression. Defibrotide is currently being tested as a component of combination chemotherapy in myeloma patients (Palumbo et al, 2010).…”