Thalidomide in induction treatment increases the very good partial response rate before and after high-dose therapy in previously untreated multiple myeloma.
In the prospective phase 3 HOVON-50/GMMG-HD3 trial, patients randomized to TAD (thalidomide, doxorubicin, dexamethasone) had a significantly higher response rate (at least PR) after induction compared with patients randomized to VAD (vincristine, adriamycin, dexamethasone, 72% vs. 54%, p<0.001). Complete remission (CR) and very good partial remission (VGPR) were also higher after TAD. After High Dose melphalan 200mg/m(2) response was comparable in both arms, 76% and 79% respectively. However, CR plus VGPR were significantly higher in the patients randomized to TAD (49% vs. 32%, p<0.001). CTC grade 3-4 adverse events were similar in both arms.
Lokhorst
Henk M
HM
Department of Hematology, University Medical Center, Utrecht, The Netherlands. h.lokhorst@umcutrecht.nl
Schmidt-Wolf
Ingo
I
Sonneveld
Pieter
P
van der Holt
Bronno
B
Martin
Hans
H
Barge
Rene
R
Bertsch
Uta
U
Schlenzka
Jana
J
Bos
Gerard M J
GM
Croockewit
Sandra
S
Zweegman
Sonja
S
Breitkreutz
Iris
I
Breitkreuz
Iris
I
Joosten
Peter
P
Scheid
Christof
C
van Marwijk-Kooy
Marinus
M
Salwender
Hans-Juergen
HJ
van Oers
Marinus H J
MH
Schaafsma
Ron
R
Naumann
Ralph
R
Sinnige
Harm
H
Blau
Igor
I
Delforge
Michel
M
Verhoef
Gregor
G
de Weerdt
Okke
O
Wijermans
Pierre
P
Wittebol
Shulamiet
S
Duersen
Ulrich
U
Vellenga
Edo
E
Goldschmidt
Hartmut
H
D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D003561:Cytarabine / Q000627:therapeutic use; D003630:Daunorubicin / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D012074:Remission Induction; D013792:Thalidomide / Q000627:therapeutic use*; D013866:Thioguanine / Q000627:therapeutic use; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use
D020533:Angiogenesis Inhibitors; D003561:Cytarabine; D013792:Thalidomide; D014750:Vincristine; D003907:Dexamethasone; D013866:Thioguanine; D003630:Daunorubicin