Thalidomide Alone or With Dexamethasone for Previously Untreated Multiple Myeloma

Weber, Donna M.; Rankin, Kim; Gavino, Maria; Delasalle, Kay; Alexanian, Raymond

doi:10.1200/jco.2003.03.139

Cited by 535 publications

(352 citation statements)

References 16 publications

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“…In line with these experimental data, Weber et al (1999) had reported that thalidomide restored the sensitivity of myeloma cells to dexamethasone-induced apoptosis. Recently, this observation was confirmed in larger cohorts by Dimopoulos et al (2001a) and Palumbo et al (2001), who reported partial responses in 41% and 55%.…”

mentioning

confidence: 57%

“…Thalidomide has been attributed with additive or even synergistic activity when combined with pulsed dexamethasone, resulting in a doubling of the response rate in myeloma patients with post-transplantation relapse and low tumour burden (Weber et al, 1999;Barlogie et al, 2000). The first experience of thalidomide in combination with dexamethasone and cytotoxic chemotherapy was reported by Barlogie et al (2000), using the T-DCEP (thalidomide, dexamethasone, cyclophosphamide, etoposide, cisplatinum) and the DT-PACE (dexamethasone, thalidomide, cisplatinum, adriamycin, cyclophosphamide, etoposide) regimens.…”

Section: Discussionmentioning

confidence: 99%

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Hyperfractionated cyclophosphamide in combination with pulsed dexamethasone and thalidomide (HyperCDT) in primary refractory or relapsed multiple myeloma

et al. 2003

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Summary. Sixty patients with advanced multiple myeloma received 2-6 monthly treatment courses combining hyperfractionated cyclophosphamide (300 mg/m 2 i.v. over 3 h q 12 h · 6, d 1-3) with pulsed dexamethasone (20 mg/m 2 /d p.o., d 1-4, 9-12, 17-20) and once daily thalidomide at individually escalating doses (100-400 mg/d) depending on tolerability (HyperCDT). Responding patients were maintained on daily thalidomide and monthly dexamethasone pulses. Complete, partial and minor response rates were 4%, 68% and 12% respectively; overall response rate was 84% (efficacy analysis). Median event-free and overall survival was 11 and 19 months respectively. During at least one treatment cycle, 67% of patients experienced grade 4 neutropenia resulting in 17% grade 3 and 9% grade 4 infections. Side-effects, presumably related to thalidomide, included neuropathy (40% grade 2, 16% grade 3), constipation (17%), oedema (5%), bradycardia (5%), skin reactions (3%), cerebrovascular events (5%) and deep vein thromboses (8%). Thromboses were not related to known thrombophilic risk factors. Four patients with prior myeloma therapy > 50 months developed myelodysplastic syndrome or secondary acute myeloid leukaemia 2-4 months after study entry. HyperCDT is a highly active and reasonably well-tolerated salvage regimen in advanced or refractory multiple myeloma.

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mentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Hyperfractionated cyclophosphamide in combination with pulsed dexamethasone and thalidomide (HyperCDT) in primary refractory or relapsed multiple myeloma

et al. 2003

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“…A higher response rate (64%) was observed only in newly diagnosed or untreated patients (Rajkumar et al, 2002). Weber et al (1999) achieved a response for THAL þ Dex in 35% of patients previously resistant to THAL or Dex alone. In our study, the combined treatment of THAL þ Dex had an increased response rate of 59.3% compared to THAL alone (55.1%).…”

Section: Discussionmentioning

confidence: 93%

An evaluation of factors predicting long-term response to thalidomide in 234 patients with relapsed or resistant multiple myeloma

et al. 2004

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The aim of this study was to assess the prognostic value of pretreatment clinical and laboratory parameters in refractory or relapsed multiple myeloma (MM) patients who have a long-term response to thalidomide (THAL), lasting at least 18 months. The study was carried out on 234 patients who received THAL for relapsed/refractory myeloma. Out of the 234 patients, 129 patients (55.1%) responded to THAL with a mean response duration of 11.9 months (ranging from 1 to 48) and an overall survival rate of 20.3 months (ranging 1 -55 months). In 64 patients (27.4% of the whole group), the response to THAL lasted X18 months with a mean response lasting 24 months. Statistical analysis of the group of nonresponders and patients with long-term response to THAL showed a significantly higher serum albumin level (P ¼ 0.0003) and haemoglobin level (P ¼ 0.05), as well as a lower b2 microglobulin (b2M) (P ¼ 0.022), LDH (P ¼ 0.045) serum level in patients with long-term response. In this study, the LDH and serum albumin level were predictors for response to THAL therapy. The b2M serum level was not a predictor for response to THAL. The albumin serum level was the best parameter distinguishing the group of patients with long-term response to THAL from the entire responding group (P ¼ 0.02).

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“…Monotherapy thalidomide trials in advanced relapsed/refractory Richardson et al, 2004) as well as previously untreated asymptomatic MM Weber et al, 2003) (also known as 'smouldering' or indolent myeloma) have consistently shown partial response rates (SWOG criteria) of approximately 30%, with an acceptable safety profile. Thalidomide combined with dexamethasone in relapsed, refractory MM induces a partial response in 56% of patients (Palumbo et al, 2004a).…”

Section: Multiple Myelomamentioning

confidence: 99%

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

Bartlett¹,

Tozer²,

Stirling³

et al. 2005

Br J Cancer

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Thalidomide Alone or With Dexamethasone for Previously Untreated Multiple Myeloma

Cited by 535 publications

References 16 publications

Hyperfractionated cyclophosphamide in combination with pulsed dexamethasone and thalidomide (HyperCDT) in primary refractory or relapsed multiple myeloma

Hyperfractionated cyclophosphamide in combination with pulsed dexamethasone and thalidomide (HyperCDT) in primary refractory or relapsed multiple myeloma

An evaluation of factors predicting long-term response to thalidomide in 234 patients with relapsed or resistant multiple myeloma

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

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