title: A modified regimen of pegylated liposomal doxorubicin, bortezomib and dexamethasone (DVD) is effective and well tolerated for previously untreated multiple myeloma patients.
abstract: The combination of pegylated liposomal doxorubicin (PLD), bortezomib and dexamethasone has shown efficacy in the treatment of multiple myeloma (MM) patients. Our earlier retrospective study suggested that modification of the doses, schedules and route of administration of these drugs appears to reduce toxicity without compromising anti-MM activity. As a result, we evaluated this modified drug combination in the frontline setting in a prospective multicentre phase II trial. Thirty-five previously untreated MM patients were enrolled. Dexamethasone IV 40 mg, bortezomib 1 mg/m(2)  and PLD 5 mg/m(2)  were administered on days 1, 4, 8 and 11 of a 4-week cycle. Patients were treated to their maximum response plus two additional cycles. The treatment regimen was discontinued after a maximum of eight cycles. Our modified schedule and dosing regimen achieved a high overall response rate of 86%, while showing a marked decrease in the incidence and severity of peripheral neuropathy, palmar-plantar erythrodysesthesia and myelosuppression compared to the standard dosing on a 3-week cycle using these drugs. This modified regimen of dexamethasone, bortezomib and PLD shows improved tolerability and safety while maintaining a high response rate when compared to standard treatment with these agents in the frontline setting.
authors.affiliation: Oncotherapeutics, James R. Berenson, MD, Inc. Institute for Myeloma and Bone Cancer Research, 9201 W. Sunset Blvd., West Hollywood, CA 90069, USA. jberenson@imbcr.org
authors.forename: James R
authors.initials: JR
authors.lastname: Berenson
authors.forename: Ori
authors.initials: O
authors.lastname: Yellin
authors.forename: Chien-Shing
authors.initials: CS
authors.lastname: Chen
authors.forename: Ravi
authors.initials: R
authors.lastname: Patel
authors.forename: Alberto
authors.initials: A
authors.lastname: Bessudo
authors.forename: Ralph V
authors.initials: RV
authors.lastname: Boccia
authors.forename: Hank H
authors.initials: HH
authors.lastname: Yang
authors.forename: Robert
authors.initials: R
authors.lastname: Vescio
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Yung
authors.forename: Russell
authors.initials: R
authors.lastname: Mapes
authors.forename: Benjamin
authors.initials: B
authors.lastname: Eades
authors.forename: James D
authors.initials: JD
authors.lastname: Hilger
authors.forename: Eric
authors.initials: E
authors.lastname: Wirtschafter
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Hilger
authors.forename: Youram
authors.initials: Y
authors.lastname: Nassir
authors.forename: Regina A
authors.initials: RA
authors.lastname: Swift
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001897:Boronic Acids / Q000008:administration & dosage / Q000009:adverse effects; D000069286:Bortezomib; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D011719:Pyrazines / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D001897:Boronic Acids; D011719:Pyrazines; C506643:liposomal doxorubicin; D011092:Polyethylene Glycols; D000069286:Bortezomib; D003907:Dexamethasone; D004317:Doxorubicin