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Bortezomib, doxorubicin, and dexamethasone combination therapy followed by thalidomide and dexamethasone consolidation as a salvage treatment for relapsed or refractory multiple myeloma: analysis of efficacy and safety

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Abstract

We conducted a phase 2 study with bortezomib, doxorubicin, and dexamethasone (PAD) followed by thalidomide and dexamethasone (TD) in patients with relapsed multiple myeloma (MM). Forty patients were enrolled between November 2005 and October 2007, with follow-up continuing until January 2009. Efficacy could be assessed in 37 patients. The overall response rate to PAD followed by TD was 83.6%: complete response 51.4%, near-complete response 13.4%, very good partial remission 5.4%, and partial response 13.4%. The median follow-up was 27 months (range 13–39). The median progression-free survival (PFS) from the start of treatment was 18 months (95% CI, 9.7–26.2 months), with a 1-year PFS rate of 56.9% and 3-year PFS rate of 25.7%. Median overall survival was 35.1 months (95% CI, 18.5–51.7), with a 1-year survival rate of 75% and 3-year survival rate of 27.3%. One hundred seventy-eight PAD cycles (median 6, range 1–6) in 38 patients were assessable for safety. The most common hematologic toxicity was thrombocytopenia, with grade 3–4 in 35.8%. Sensory neuropathy occurred at grade 2 in 26.3% and grade 3 in 10.3%. Two hundred TD treatment cycles (median 4, range 0–12 cycles) were administered. Most adverse events were of mild degree and manageable. PAD followed by TD in patients with relapsed MM is very effective and tolerable.

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Authors and Affiliations

  1. Yonsei Cancer Center, Severance Hospital, Seoul, South Korea

    Sung Sook Lee

  2. Asan Medical Center, Seoul, South Korea

    Cheolwon Suh

  3. Seoul Veterans Hospital, Seoul, South Korea

    Bong-Seog Kim

  4. Busan National University Hospital, Busan, South Korea

    Jooseop Chung

  5. Busan Paik Hospital, Busan, South Korea

    Young-Don Joo

  6. Daegu Catholic University Hospital, Daegu, South Korea

    Hun-Mo Ryoo

  7. Keimyung University, Dongsan Medical Center, Daegu, South Korea

    Young Rok Do

  8. Bucheon St. Mary’s Hospital, The Catholic University of Korea, Seoul, South Korea

    Jong-Youl Jin

  9. Korea Institute of Radiological and Medical Sciences, Seoul, South Korea

    Hye Jin Kang

  10. Gyeongsang National University Hospital, Jinju, South Korea

    Gyeong-Won Lee

  11. Inha University Hospital, Incheon, South Korea

    Moon Hee Lee

  12. Wonkwang University Hospital, Iksan, South Korea

    Hyeok Shim

  13. Sungkyunkwan University Samsung Medical Center, Seoul, South Korea

    Kihyun Kim

  14. Seoul National University College of Medicine, Seoul, South Korea

    Sung-Soo Yoon & Dong Soon Lee

  15. Seoul National University Bundang Hospital, Seoul, South Korea

    Soo Mee Bang

  16. Hallym University Medical Center, Seoul, South Korea

    Ho Young Kim

  17. Chonnam National University Hwasun Hospital, Gwangju, South Korea

    Je-Jung Lee

  18. Gachon University Gil Hospital, Incheon, South Korea

    Jinny Park & Jae-Hoon Lee

  19. Division of Hematology/Oncology, Gachon University Gil Hospital, 1198 Guwol-dong Namdong-gu, Incheon, South Korea, 405-220

    Jae-Hoon Lee

Authors
  1. Sung Sook Lee
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  2. Cheolwon Suh
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  11. Moon Hee Lee
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  16. Ho Young Kim
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  18. Jinny Park
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  19. Dong Soon Lee
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  20. Jae-Hoon Lee
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the Korean Multiple Myeloma Working Party (KMMWP)

Corresponding author

Correspondence to Jae-Hoon Lee.

Additional information

Sung Sook Lee and Cheolwon Suh equally contributed to this article.

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Lee, S.S., Suh, C., Kim, BS. et al. Bortezomib, doxorubicin, and dexamethasone combination therapy followed by thalidomide and dexamethasone consolidation as a salvage treatment for relapsed or refractory multiple myeloma: analysis of efficacy and safety. Ann Hematol 89, 905–912 (2010). https://doi.org/10.1007/s00277-010-0943-z

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  • DOI: https://doi.org/10.1007/s00277-010-0943-z

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