Abstract
Thalidomide with dexamethasone (thal-dex) is an active therapy for patients with relapsed or refractory multiple myeloma (MM). In this Practice Point, we discuss the findings of a trial by Rajkumar et al. that aimed to compare the response rate, time to progression and progression-free survival among previously untreated patients with MM who received either thal-dex or placebo plus dexamethasone. The thal-dex regimen was associated with a significantly higher response rate at the expense of more-frequent adverse effects, in particular deep-vein thrombosis, which occurred in almost 20% of patients. Median time to progression was three times longer with thal-dex than with placebo plus dexamethasone, but was shorter, however, than the time to progression observed in studies in which thalidomide or bortezomib was added to melphalan and prednisone. Nevertheless, thal-dex is a convenient oral and relatively inexpensive non-myelosuppressive regimen, which can be used in patients with previously untreated MM.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Singhal S et al. (1999) Antitumor activity of thalidomide in refractory multiple myeloma. N Engl J Med 341: 1565–1571
Rajkumar SV et al. (2006) Phase III clinical trial of thalidomide plus dexamethasone compared with dexamethasone alone in newly diagnosed multiple myeloma: a clinical trial coordinated by the Eastern Cooperative Oncology Group. J Clin Oncol 24: 431–436
Rajkumar SV et al. (2008) Multicenter, randomized, double-blind, placebo-controlled study of thalidomide plus dexamethasone compared with dexamethasone as initial therapy for newly diagnosed multiple myeloma. J Clin Oncol 26: 2171–2177
Harousseau JL et al. (2008) Bortezomib/dexamethasone versus VAD as induction prior to autologous stem cell transplantation (ASCT) in previously untreated multiple myeloma (MM): updated data from IFM 2005/01 trial. In Proceedings of the American Society of Clinical Oncology Annual Meeting: 2008 May 30–June 3; Chicago, IL; abstract #8505
Cavo M et al. (2007) Bortezomib (Velcade(R))-thalidomide-dexamethasone (VTD) vs thalidomide-dexamethasone (TD) in preparation for autologous stem-cell (SC) transplantation (ASCT) in newly diagnosed multiple myeloma (MM). Blood (ASH Annual Meeting Abstracts) 110: abstract #73
Palumbo A et al. (2007) A new standard of care for elderly patients with myeloma. Lancet 370: 1191–1192
Ludwig H et al. (2007) Thalidomide-dexamethasone vs melphalan-prednisone as first line treatment and thalidomide-interferon vs interferon maintenance therapy in elderly patients with multiple myeloma. Blood (ASH Annual Meeting Abstracts) 110: abstract #529
San Miguel JF et al. (2007) MMY-3002: a phase 3 study comparing bortezomib-melphalan-prednisone (VMP) with melphalan-prednisone (MP) in newly diagnosed multiple myeloma. Blood (ASH Annual Meeting Abstracts) 110: abstract #76
Rajkumar SV et al. (2007) A randomized trial of lenalidomide plus high-dose dexamethasone (RD) versus lenalidomide plus low-dose dexamethasone (Rd) in newly diagnosed multiple myeloma (E4A03): a trial coordinated by the Eastern Cooperative Oncology Group. Blood (ASH Annual Meeting Abstracts) 110: abstract #74
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing financial interests.
Rights and permissions
About this article
Cite this article
Dimopoulos, M., Kastritis, E. Thalidomide plus dexamethasone as primary therapy for newly diagnosed patients with multiple myeloma. Nat Rev Clin Oncol 5, 690–691 (2008). https://doi.org/10.1038/ncponc1223
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/ncponc1223