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[Thalidomide with or without dexamethasone for refractory multiple myeloma].
M Boulin1, F Blanchet, N Isambert
1Service Pharmacie, C.H.U. Bocage, Boulevard Maréchal De Lattre De Tassigny, Dijon, France. mathbouw@yahoo.fr
Therapie
|April 2, 2003
Summary
Thalidomide showed a 33% response rate in refractory multiple myeloma patients. Combining thalidomide with dexamethasone yielded a higher response rate, suggesting further study for this multiple myeloma treatment.
Area of Science:
- Hematology
- Clinical Oncology
- Pharmacology
Context:
- Refractory multiple myeloma presents a significant clinical challenge with limited treatment options.
- Thalidomide emerged as a potential therapeutic agent for multiple myeloma in 1999.
- Previous studies indicated thalidomide's efficacy in patients resistant to standard therapies.
Purpose:
- To evaluate the efficacy and safety of thalidomide monotherapy in patients with refractory multiple myeloma.
- To assess the response rate and progression-free survival of thalidomide treatment.
- To explore the potential benefit of combining thalidomide with dexamethasone in this patient population.
Summary:
- Twenty-one patients with refractory multiple myeloma received thalidomide at 400 mg/day, achieving a 33% response rate and 15-month median progression-free survival.
- Common side effects included drowsiness and constipation, with five patients developing peripheral neuropathy.
- Eight patients received combination therapy with thalidomide and dexamethasone (with or without chemotherapy), resulting in a high response rate.
Impact:
- The findings suggest that thalidomide is an active agent in refractory multiple myeloma.
- Combination therapy with thalidomide and dexamethasone appears promising and warrants further investigation.
- A prospective, randomized trial comparing thalidomide/dexamethasone combination to thalidomide monotherapy is recommended for optimal refractory multiple myeloma treatment.