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Bortezomib in combination with pegylated liposomal doxorubicin and thalidomide is an effective steroid independent salvage regimen for patients with relapsed or refractory multiple myeloma: results of a phase II clinical trial *  

Authors: Asher Chanan-Khanab; Kena C. Millera; Laurie Musialc; Swaminathan Padmanabhana; Jihnhee Yud; Sikander Ailawadhia; Taimur Shera; Alice Mohra; Zale P. Bernsteina; Maurice Barcose; Mehul Patela; Dan Iancue; Kelvin Leeaf; Myron S. Czuczmana
Affiliations:   a Department of Medicine,
b Department of Molecular Targets and Experimental Therapeutics,
c Department of Clinical Research Services,
d Department of Biostatistics,
e Department of Pathology and Immunology,
f Department of Immunology, Roswell Park Cancer Institute, State University of New York, Buffalo, NY, USA
DOI: 10.1080/10428190902912460
Publication Frequency: 12 issues per year
Published in: journal Leukemia and Lymphoma, Volume 50, Issue 7 July 2009 , pages 1096 - 1101
First Published: July 2009
Formats available: HTML (English) : PDF (English)
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Abstract

Novel agents have demonstrated enhanced efficacy when combined with other antimyeloma agents especially dexamethasone. The steroid doses employed in myeloma regimens are often poorly tolerated. Therefore, in a phase II clinical trial we investigated the efficacy of a steroid-free combination including bortezomib, pegylated liposomal doxorubicin and thalidomide (VDT regimen). Twenty-three patients with relapsed or refractory myeloma or other plasma cell cancers were treated with the VDT regimen. Patient had a median of five prior therapies and 65.2% were refractory to their last regimen. The overall response rates were 55.5% and 22%, respectively. The median progression free survival was 10.9 months (95% CI: 7.3-15.8) and the median overall survival was 15.7 months (95% CI: 9.1-not reached). Fatigue and sensory neuropathy were the most common side effects noted. We observe that VDT is an effective steroid-free regimen with ability to induce durable remission even in patients with refractory myeloma.
* Preliminary results of this study were presented at the European Hematology Association Meeting in Amsterdam, Netherlands (2006), and at the 48th Annual Meeting of the American Society of Hematology (ASH) in Orlando, Florida (2006).
Keywords: Multiple myeloma; bortezomib; non-steroidal; doxil; relapsed/refractory
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