Clinical experience with thalidomide in multiple myeloma: Phase II trial results in refractory disease and ongoing studies
| Autor: | Bart Barlogie, Nikhil C. Munshi, K. R. Desikan |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Oncology
medicine.medical_specialty Chemotherapy business.industry medicine.medical_treatment Refractory Disease Hematology medicine.disease law.invention Clinical trial Thalidomide medicine.anatomical_structure Randomized controlled trial law Internal medicine Immunopathology Immunology medicine Bone marrow business Multiple myeloma medicine.drug |
| Zdroj: | Seminars in Hematology. 37:15-21 |
| ISSN: | 0037-1963 |
| DOI: | 10.1016/s0037-1963(00)90078-7 |
| Popis: | High-dose chemotherapy with autologous stem-cell transplant has markedly increased complete response (CR) and event-free survival (EFS) and overall survival (OS) rates in multiple myeloma. In fact, patients with no adverse prognostic factors achieve prolonged disease-free survival with this strategy. However, a substantial proportion of patients eventually relapse, perpetuating the need for newer agents and therapies. Recent findings that multiple myeloma is associated with neoangiogenesis and an increased number of microvessels in bone marrow, which carries a poor prognosis, led to the compassionate use of thalidomide for advanced multiple myeloma. A rapid, profound, and durable objective response to thalidomide in a pilot patient prompted initiation of a phase II clinical trial of single-agent thalidomide for advanced and refractory multiple myeloma. Preliminary results of this study suggest that thalidomide is highly active and well tolerated, even in patients who relapse after several induction attempts with high-dose chemotherapy and hematopoietic support. Based on this encouraging experience, randomized clinical trials evaluating the addition of thalidomide to cytotoxic treatment strategies for newly diagnosed and advanced refractory multiple myeloma are underway. Further research to establish the mechanism of antitumor activity and a dose-response relationship for thalidomide in multiple myeloma is required. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|