Bortezomib in combination with pegylated liposomal doxorubicin and thalidomide is an effective steroid independent salvage regimen for patients with relapsed or refractory multiple myeloma: results of a phase II clinical trial.
Novel agents have demonstrated enhanced efficacy when combined with other antimyeloma agents especially dexamethasone. The steroid doses employed in myeloma regimens are often poorly tolerated. Therefore, in a phase II clinical trial we investigated the efficacy of a steroid-free combination including bortezomib, pegylated liposomal doxorubicin and thalidomide (VDT regimen). Twenty-three patients with relapsed or refractory myeloma or other plasma cell cancers were treated with the VDT regimen. Patient had a median of five prior therapies and 65.2% were refractory to their last regimen. The overall response rates were 55.5% and 22%, respectively. The median progression free survival was 10.9 months (95% CI: 7.3-15.8) and the median overall survival was 15.7 months (95% CI: 9.1-not reached). Fatigue and sensory neuropathy were the most common side effects noted. We observe that VDT is an effective steroid-free regimen with ability to induce durable remission even in patients with refractory myeloma.
Chanan-Khan
Asher
A
Department of Medicine, Roswell Park Cancer Institute, State University of New York, Buffalo, NY 14051, USA. asher.chanan-khan@roswellpark.org
Miller
Kena C
KC
Musial
Laurie
L
Padmanabhan
Swaminathan
S
Yu
Jihnhee
J
Ailawadhi
Sikander
S
Sher
Taimur
T
Mohr
Alice
A
Bernstein
Zale P
ZP
Barcos
Maurice
M
Patel
Mehul
M
Iancu
Dan
D
Lee
Kelvin
K
Czuczman
Myron S
MS
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001897:Boronic Acids / Q000008:administration & dosage*; D000069286:Bortezomib; D004317:Doxorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011719:Pyrazines / Q000008:administration & dosage*; D012074:Remission Induction; D016879:Salvage Therapy / Q000379:methods; D013256:Steroids / Q000627:therapeutic use; D013792:Thalidomide / Q000008:administration & dosage*; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D013256:Steroids; C506643:liposomal doxorubicin; D011092:Polyethylene Glycols; D013792:Thalidomide; D000069286:Bortezomib; D004317:Doxorubicin