Thalidomide with or without dexamethasone for refractory or relapsing multiple myeloma

Final Report of Toxicity and Efficacy of a Phase II Study of Oral Cyclophosphamide, Thalidomide, and Prednisone for Patients with Relapsed or Refractory Multiple Myeloma: A Hoosier Oncology Group Trial, HEM01-21

“…Neuropathy was manageable with a rapid-dose modification of thalidomide. Severe thrombosis occurred in 8% of patients, which is comparable to other reports [6,33]. The pathophysiology of thrombosis in this setting is poorly understood.…”

“…Although the antiangiogenic effect of thalidomide led to its investigation in MM, thalidomide has multifaceted effects in MM that include the direct cytotoxicity to MM cells, the alteration of cytokines in the microenvironment, and immunomodulatory effects such as T-and natural killer cell activation [2][3][4][5]. Despite its benefit, significant toxicities of thalidomide occur, including neuropathy, sedation, and thrombosis [6,7]. Efforts in overcoming thalidomide toxicity include the chemical modification of the compound [8] and the use of a lower dose of thalidomide in combination with other agents.…”

Targeted treatments to improve stem cell outcome: old and new drugs

“…6 Since then, thalidomide has been widely used as a single agent in heavily pretreated and relapsed or refractory multiple myeloma. [7][8][9][10][11][12][13][14][15][16][17] In vitro studies revealed synergistic activity between dexamethasone (Dex) and thalidomide. 18 Combining thalidomide and Dex in clinical trials clearly represented an advance in treatment options for relapsed MM with overall responses up to 55%.…”

Bortezomib (Velcade) for progressive myeloma after autologous stem cell transplantation and thalidomide

“…after AuSCT [4][5][6][7]. Despite the initial efficacy of these therapies, however, relapse is invariably the rule.…”