A steroid-independent regimen of bortezomib, liposomal doxorubicin and thalidomide demonstrate high response rates in newly diagnosed multiple myeloma patients

作者：Sher Taimur; Ailawadhi Sikander; Miller Kena C; Manfredi Debbie; Wood Margaret; Tan Wei; Wilding Gregory; Czuczman Myron S; Hernandez Ilizaliturri Francisco J; Hong Fredrick; Sood Raman; Soniwala Saif; Lawrence William; Jamshed Saad; Masood Aisha; Iancu Daniel; Lee Kelvin; Chanan Khan Asher^*

来源：British Journal of Haematology, 2011, 154(1): 104-110.

DOI：10.1111/j.1365-2141.2011.08703.x

• multiple myeloma
• clinical trials
• steroids
• thalidomide
• newly diagnosed multiple myeloma

Novel agents have provided a new foundation for multiple myeloma therapies. When combined with other anti-myeloma agents, these compounds significantly enhance clinical efficacy. High-dose steroids are frequently used in anti-myeloma combination regimens; however, the doses employed are often poorly tolerated, especially in patients with concurrent comorbid conditions. We hypothesized that a steroid-independent combination regimen could be developed without significant compromise of efficacy. The availability of such a regimen will be important for patients whose concurrent ailments make them poor candidates for steroid containing anti-myeloma regimens. A phase II single institute, non-randomized clinical trial was conducted to investigate a novel steroid-free three-drug combination of bortezomib (V), pegylated liposomal doxorubicin (D), and thalidomide (T), the VDT regimen. Forty-three newly diagnosed multiple myeloma patients requiring treatment were enrolled on this study. The overall response rate and complete response (CR) + near complete response (nCR) rate was 78% and 35%, respectively. Median time to progression was 29.5 months. Fatigue, rash, neuropathy, constipation and infections were the most common side effects. We concluded that VDT is a tolerable and an effective regimen capable of inducing high response rates and can be employed in patients considered to be poor candidates for steroid-based treatment regimens.

• 出版日期2011-7