title: Thalidomide, clarithromycin, lenalidomide and dexamethasone therapy in newly diagnosed, symptomatic multiple myeloma.
abstract: We studied T-BiRD (thalidomide [Thalomid(®)], clarithromycin [Biaxin(®)], lenalidomide [Revlimid(®)] and dexamethasone) in symptomatic, newly diagnosed multiple myeloma. In 28-day cycles, patients received dexamethasone 40 mg/day on days 1, 8, 15, 22, clarithromycin 500 mg twice daily on days 1-28; lenalidomide 25 mg/day on days 1-21; and thalidomide 100 mg/day (50 mg/day on days 1-7 of cycle 1 only) on days 1-28. Twenty-six patients received a median of 6 cycles (range 0-41). Overall response rate (ORR) was 80% for the group and 100% in 11 patients who underwent autologous stem cell transplantation as part of first-line therapy. The 4-year overall survival rate was 74.9%, and the median progression-free survival was 35.6 months. Eight patients discontinued due to regimen toxicity. Grade 3 non hematologic toxicity affected 12 patients (46.2%). T-BiRD is a highly active regimen with potential toxicity limitations. ClinicalTrials.gov identifier: NCT00538733.
authors.affiliation: Center of Excellence for Lymphoma and Myeloma, Weill Medical College of Cornell University, New York Presbyterian Hospital , New York, NY , USA.
authors.forename: Tomer M
authors.initials: TM
authors.lastname: Mark
authors.forename: Isaac A
authors.initials: IA
authors.lastname: Bowman
authors.forename: Adriana C
authors.initials: AC
authors.lastname: Rossi
authors.forename: Manan
authors.initials: M
authors.lastname: Shah
authors.forename: Melissa
authors.initials: M
authors.lastname: Rodriguez
authors.forename: Ryann
authors.initials: R
authors.lastname: Quinn
authors.forename: Roger N
authors.initials: RN
authors.lastname: Pearse
authors.forename: Faiza
authors.initials: F
authors.lastname: Zafar
authors.forename: Karen
authors.initials: K
authors.lastname: Pekle
authors.forename: David
authors.initials: D
authors.lastname: Jayabalan
authors.forename: Scott
authors.initials: S
authors.lastname: Ely
authors.forename: Morton
authors.initials: M
authors.lastname: Coleman
authors.forename: Selina
authors.initials: S
authors.lastname: Chen-Kiang
authors.forename: Ruben
authors.initials: R
authors.lastname: Niesvizky
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017291:Clarithromycin / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D009367:Neoplasm Staging; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D013792:Thalidomide; D003907:Dexamethasone; D000077269:Lenalidomide; D017291:Clarithromycin
keywords: Newly diagnosed multiple myeloma; clarithromycin; dexamethasone; lenalidomide; thalidomide