Clinical trials of myeloma treatment: a review

Clinical trials of myeloma treatment are reviewed. 7618 patients are described in nine Tables (some patients appear in more than one). Most randomized trials and trials of non-staged myeloma yield no statistically significant differences between the combinations of alkylators, vinca alkaloids, nitrosoureas, anthracyclines, epipodophyllotoxins, procarbazine and/or steroids used. Intensive combination treatment induces response in an average of 3 months and seems superior to monotherapy in stage III, in which the early mortality is reduced from 45% to 10%. No studies were found showing any evidence for superiority of intensive treatment in stage I. Alternating chemotherapy combinations do not delay refractoriness. No evidence was found that maintenance treatment prolongs survival in responding patients.