Thalidomide in induction treatment increases the very good partial response rate before and after high-dose therapy in previously untreated multiple myeloma

• Published in: Haematologica (Roma) Vol. 93; no. 1; pp. 124 - 127
• Main Authors: Lokhorst, Henk M, Schmidt-Wolf, Ingo, Sonneveld, Pieter, van der Holt, Bronno, Martin, Hans, Barge, Rene, Bertsch, Uta, Schlenzka, Jana, Bos, Gerard M.J, Croockewit, Sandra, Zweegman, Sonja, Breitkreutz, Iris, Joosten, Peter, Scheid, Christof, van Marwijk-Kooy, Marinus, Salwender, Hans-Juergen, van Oers, Marinus H.J, Schaafsma, Ron, Naumann, Ralph, Sinnige, Harm, Blau, Igor, Delforge, Michel, de Weerdt, Okke, Wijermans, Pierre, Wittebol, Shulamiet, Duersen, Ulrich, Vellenga, Edo, Goldschmidt, Hartmut, for Dutch-Belgian HOVON and German GMMG
• Format: Journal Article
• Language: English
• Published: Pavia Haematologica 01-01-2008; Ferrata Storti Foundation
• Subjects: Adult; Aged; Angiogenesis Inhibitors - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Cytarabine - therapeutic use; Daunorubicin - therapeutic use; Dexamethasone - therapeutic use; Female; Hematologic and hematopoietic diseases; Humans; Immunodeficiencies. Immunoglobulinopathies; Immunoglobulinopathies; Immunopathology; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical Oncology - methods; Medical sciences; Middle Aged; Multiple Myeloma - drug therapy; Remission Induction; Thalidomide - therapeutic use; Thioguanine - therapeutic use; Treatment Outcome; Vincristine - therapeutic use; Antineoplastic agent; Immunopathology; Hematology; Response rate; Malignant hemopathy; Myeloma; Anti-Tumor Necrosis Factor-alpha; Induction treatment; Immunoglobulinopathy; Partial; Lymphoproliferative syndrome; High dose; Thalidomide; Cancer; untreated multiple myeloma
• ISSN: 0390-6078; 1592-8721
• DOI: 10.3324/haematol.11644

1 Dutch-Belgian Hemato-Oncology Cooperative Group (HOVON), The Netherlands and 2 German GMMG
Correspondence: H.M. Lokhorst, Dept. of Hematology, University Medical Center, Utrecht, The Netherlands. E-mail: h.lokhorst{at}umcutrecht.nl
In the prospective phase 3 HOVON-50/GMMG-HD3 trial, patients randomized to TAD (thalidomide, doxorubicin, dexamethasone) had a significantly higher response rate (at least PR) after induction compared with patients randomized to VAD (vincristine, adriamycin, dexamethasone, 72% vs. 54%, p <0.001). Complete remission (CR) and very good partial remission (VGPR) were also higher after TAD. After High Dose melphalan 200mg/m 2 response was comparable in both arms, 76% and 79% respectively. However, CR plus VGPR were significantly higher in the patients randomized to TAD (49% vs. 32%, p <0.001). CTC grade 3–4 adverse events were similar in both arms.
Key words: thalidomide, untreated multiple myeloma.