A systematic review of phase II trials of thalidomide/dexamethasone combination therapy in patients with relapsed or refractory multiple myeloma.
Thalidomide monotherapy in relapsed/refractory multiple myeloma (MM) has a response rate of 30%. The combination of thalidomide with dexamethasone (Thal/Dex) is expected to improve responses, but it is unknown if the combination increases the rate of adverse events. Here, we conducted a systematic review of studies evaluating Thal/Dex in relapsed/refractory MM. Twelve studies were included, comprising 451 patients. The response rate (CR and PR) was 46% (95% CI 42-51%). Therapy-related toxicity was comparable to thalidomide monotherapy and included somnolence (26%, 95% CI 22-31%), constipation (37%, 95% CI 32-42%) and peripheral neuropathy (27%, 95% CI 23-32%). Only venous thromboembolism appeared to occur more often with Thal/Dex (5%, 95% CI 3-8%). Thus, using Thal/Dex results in an improved response rate in relapsed/refractory MM, with a toxicity rate comparable to thalidomide monotherapy.
von Lilienfeld-Toal
Marie
M
Medizinische Klinik und Poliklinik III, Rheinische Friedrich Wilhelms Universität, Bonn, Germany. m.lilienfeld.toal@uni-bonn.de
Hahn-Ast
Corinna
C
Furkert
Kerstin
K
Hoffmann
Florian
F
Naumann
Ralph
R
Bargou
Ralf
R
Cook
Gordon
G
Glasmacher
Axel
A
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D017322:Clinical Trials, Phase II as Topic; D003248:Constipation / Q000139:chemically induced; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects; D006970:Disorders of Excessive Somnolence / Q000139:chemically induced; D006801:Humans; D015201:Meta-Analysis as Topic; D009101:Multiple Myeloma / Q000188:drug therapy*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced; D012008:Recurrence; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects; D054556:Venous Thromboembolism / Q000139:chemically induced
D013792:Thalidomide; D003907:Dexamethasone