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Thalidomide and dexamethasone combination for refractory multiple myeloma.

M A Dimopoulos¹, K Zervas, G Kouvatseas

¹Department of Clinical Therapeutics, University of Athens School of Medicine, Greece. mdimop@cc.uoa.gr

Annals of Oncology : Official Journal of the European Society for Medical Oncology

|August 28, 2001

Summary

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This study shows that combining thalidomide with dexamethasone is an effective salvage treatment for refractory multiple myeloma patients, with manageable side effects. Further research is recommended for broader applications.

Area of Science:

Hematology
Oncology
Pharmacology

Background:

Thalidomide shows efficacy in 30% of refractory multiple myeloma cases.
Dexamethasone is active in 25% of patients with chemotherapy-resistant disease.

Purpose of the Study:

To evaluate the efficacy and toxicity of combining thalidomide and dexamethasone.
To assess this combination as a salvage treatment for heavily pretreated multiple myeloma patients.

Main Methods:

Forty-four refractory multiple myeloma patients received thalidomide (200-400 mg daily) and intermittent dexamethasone (20 mg/m2).
Patients had a median age of 67 and were resistant to standard therapies, including dexamethasone and high-dose therapy.

Main Results:

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A partial response was achieved by 55% of patients (24/44), with a median response time of 1.3 months.

The combination was effective regardless of prior resistance to dexamethasone or high-dose therapy.

Toxicities were mild/moderate, including constipation, somnolence, tremor, xerostomia, and neuropathy. Median survival was 12.6 months.

Conclusions:

Thalidomide and dexamethasone combination demonstrates activity in refractory multiple myeloma.
Further studies are warranted to explore this combination as second-line or primary treatment for multiple myeloma.