title: 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.
abstract: 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.
authors.affiliation: Department of Medicine, Roswell Park Cancer Institute, State University of New York, Buffalo, NY 14051, USA. asher.chanan-khan@roswellpark.org
authors.forename: Asher
authors.initials: A
authors.lastname: Chanan-Khan
authors.forename: Kena C
authors.initials: KC
authors.lastname: Miller
authors.forename: Laurie
authors.initials: L
authors.lastname: Musial
authors.forename: Swaminathan
authors.initials: S
authors.lastname: Padmanabhan
authors.forename: Jihnhee
authors.initials: J
authors.lastname: Yu
authors.forename: Sikander
authors.initials: S
authors.lastname: Ailawadhi
authors.forename: Taimur
authors.initials: T
authors.lastname: Sher
authors.forename: Alice
authors.initials: A
authors.lastname: Mohr
authors.forename: Zale P
authors.initials: ZP
authors.lastname: Bernstein
authors.forename: Maurice
authors.initials: M
authors.lastname: Barcos
authors.forename: Mehul
authors.initials: M
authors.lastname: Patel
authors.forename: Dan
authors.initials: D
authors.lastname: Iancu
authors.forename: Kelvin
authors.initials: K
authors.lastname: Lee
authors.forename: Myron S
authors.initials: MS
authors.lastname: Czuczman
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D013256:Steroids; C506643:liposomal doxorubicin; D011092:Polyethylene Glycols; D013792:Thalidomide; D000069286:Bortezomib; D004317:Doxorubicin