title: BiRd (clarithromycin, lenalidomide, dexamethasone): an update on long-term lenalidomide therapy in previously untreated patients with multiple myeloma.
abstract: The combination of clarithromycin, lenalidomide, and dexamethasone (BiRd) was evaluated as therapy for treatment-naive symptomatic multiple myeloma (MM), with overall response at 2 years of 90%. We reviewed the long-term follow-up of initial BiRd therapy. Seventy-two patients were given dexamethasone 40 mg weekly, clarithromycin 500 mg twice daily, and lenalidomide 25 mg daily on days 1 to 21 of a 28-day cycle. After a median follow-up of 6.6 years, overall response rates were 93%, with a very good partial response or better of 68%. Median progression-free survival was 49 months. Evaluation for the development of second primary malignancies (SPMs) was conducted, and no increase in incidence was noted in our cohort of patients who received frontline immunomodulatory therapy. BiRd remains a highly potent and safe regimen for frontline therapy in patients with MM without apparent increase in risk of SPMs. This trial was registered at www.clinicaltrials.gov as #NCT00151203.
authors.affiliation: Division of Hematology and Medical Oncology, Department of Medicine, Myeloma Center, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY 10021, USA. run9001@med.cornell.edu
authors.forename: Adriana
authors.initials: A
authors.lastname: Rossi
authors.forename: Tomer
authors.initials: T
authors.lastname: Mark
authors.forename: David
authors.initials: D
authors.lastname: Jayabalan
authors.forename: Paul
authors.initials: P
authors.lastname: Christos
authors.forename: Faiza
authors.initials: F
authors.lastname: Zafar
authors.forename: Karen
authors.initials: K
authors.lastname: Pekle
authors.forename: Roger
authors.initials: R
authors.lastname: Pearse
authors.forename: Selina
authors.initials: S
authors.lastname: Chen-Kiang
authors.forename: Morton
authors.initials: M
authors.lastname: Coleman
authors.forename: Ruben
authors.initials: R
authors.lastname: Niesvizky
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017291:Clarithromycin / Q000008:administration & dosage* / Q000009:adverse effects; D017322:Clinical Trials, Phase II as Topic; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D000077269:Lenalidomide; D060046:Maintenance Chemotherapy / Q000379:methods; D008297:Male; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D020360:Neoadjuvant Therapy; D012189:Retrospective Studies; D016019:Survival Analysis; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D014182:Transplantation, Autologous
chemical_list: D013792:Thalidomide; D003907:Dexamethasone; D000077269:Lenalidomide; D017291:Clarithromycin