Literature DB >> 12528875

Response rate, durability of response, and survival after thalidomide therapy for relapsed multiple myeloma.

Shaji Kumar1, Morie A Gertz, Angela Dispenzieri, Martha Q Lacy, Susan M Geyer, Nancy L Iturria, Rafael Fonseca, Suzanne R Hayman, John A Lust, Robert A Kyle, Philip R Greipp, Thomas E Witzig, S Vincent Rajkumar.   

Abstract

OBJECTIVE: To assess response rate, duration of response, progression-free survival, and toxicity of thalidomide in patients with relapsed multiple myeloma. PATIENTS AND METHODS: Thirty-two patients with relapsed multiple myeloma were entered into the study between April 29, 1999, and June 20, 2000. They were given oral thalidomide at a dosage of 200 mg/d for 2 weeks, which was then increased as tolerated to a maximum of 800 mg/d. The primary end point of the study was response rate.
RESULTS: The median age of the patients was 67 years (range, 36-78 years). Prior chemotherapy had failed in all patients, and stem cell transplantation had failed in 5 patients (16%). There were 10 confirmed responses, yielding a response rate of 31%. In addition, there was 1 unconfirmed partial response and 7 minimal responses with no complete responses. The median duration of response was 11.9 months (range, 3.7-203 months). Overall, 20 patients have died, and 26 patients have experienced disease progression. The median follow-up of surviving patients was 28.5 months (range, 193-34.0 months), with a median progression-free survival of 8.6 months (95% confidence interval [CI], 4.7-16 months). The median progression-free survival among the responding patients was 15.7 months (95% CI, 8.6-25.6 months). The median overall survival for the entire group was 22 months (95% CI, 10.6-35.9 months). The most common treatment-related nonhematologic toxic effects (grade >3) were neuropathy (16%), sedation (13%), febrile neutropenia (6%), and constipation (6%).
CONCLUSIONS: Thalidomide is useful in the treatment of patients with relapsed multiple myeloma and produced durable response in approximately one third of patients, with median response duration of nearly 1 year.

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Year:  2003        PMID: 12528875     DOI: 10.4065/78.1.34

Source DB:  PubMed          Journal:  Mayo Clin Proc        ISSN: 0025-6196            Impact factor:   7.616


  21 in total

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Review 4.  Management of relapsed multiple myeloma: recommendations of the International Myeloma Working Group.

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Review 5.  Treatment strategies in elderly patients with multiple myeloma: current status.

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6.  Outcomes of primary refractory multiple myeloma and the impact of novel therapies.

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Review 7.  Venous and arterial thrombotic risks with thalidomide: evidence and practical guidance.

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Review 8.  Therapy strategies for multiple myeloma: current status.

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Journal:  Wien Klin Wochenschr       Date:  2003-08-14       Impact factor: 1.704

9.  Multicenter, randomized, double-blind, placebo-controlled study of thalidomide plus dexamethasone compared with dexamethasone as initial therapy for newly diagnosed multiple myeloma.

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Review 10.  Immune responses in multiple myeloma: role of the natural immune surveillance and potential of immunotherapies.

Authors:  Camille Guillerey; Kyohei Nakamura; Slavica Vuckovic; Geoffrey R Hill; Mark J Smyth
Journal:  Cell Mol Life Sci       Date:  2016-01-22       Impact factor: 9.261

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