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Analysis of the Efficacy of Thalidomide Plus Dexamethasone-Based Regimens in Patients With Relapsed/Refractory Multiple Myeloma Who Received Prior Chemotherapy, Including Bortezomib and Lenalidomide: KMM-166 Study

 Ki Sun Jung  ;  Kihyun Kim  ;  Hyo Jung Kim  ;  Sung Hyun Kim  ;  Jeong-Ok Lee  ;  Jin Seok Kim  ;  Je-Jung Lee  ;  Hyeon-Seok Eom  ;  Chang-Ki Min  ;  Ho-Jin Shin 
 CLINICAL LYMPHOMA MYELOMA & LEUKEMIA, Vol.20(2) : E97-E104, 2020-02 
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Issue Date
Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols / pharmacology ; Antineoplastic Combined Chemotherapy Protocols / therapeutic use* ; Bortezomib / pharmacology ; Bortezomib / therapeutic use* ; Dexamethasone / pharmacology ; Dexamethasone / therapeutic use* ; Female ; Humans ; Lenalidomide / pharmacology ; Lenalidomide / therapeutic use* ; Male ; Middle Aged ; Multiple Myeloma / drug therapy* ; Neoplasm Recurrence, Local ; Retrospective Studies ; Thalidomide / pharmacology ; Thalidomide / therapeutic use* ; Treatment Outcome
Lenalidomide ; Multiple myeloma ; Refractory ; Relapsed ; Thalidomide
For patients with multiple myeloma (MM) that relapsed after treatment with bortezomib- and lenalidomide-based regimens, there were no other treatment options in Korea until 2016. Thalidomide plus a dexamethasone-based regimen is one of the treatment options for patients with relapsed/refractory MM, even after treatment with prior immunomodulatory agents, including thalidomide and lenalidomide. Background: For patients with multiple myeloma (MM) that relapsed after treatment with bortezomib- and lenalidomide-based regimens, there were no other treatment options in Korea until 2016. We aimed to determine the efficacy of thalidomide plus dexamethasone-based regimens in patients with relapsed/refractory MM (RRMM). Patients and Methods: We conducted a multicenter retrospective analysis in Korea for patients with RRMM treated with thalidomide-based regimens who previously received bortezomib and immunomodulatory agents (IMiDs), including thalidomide and lenalidomide. Results: In 47 patients with RRMM, the median age was 64 years and the median number of previous treatment lines, including bortezomib and IMiDs, was 3. Primary resistance to bortezomib and lenalidomide was observed in 12 (26%) and 8 (17%) patients, respectively. The most common regimen was a combination of thalidomide, cyclophosphamide, and dexamethasone. The overall response rate was 38%; 2 patients (4%) experienced a complete response, and 2 patients (4%) experienced a very good partial response. The overall response rate of patients previously exposed to thalidomide was 53%. The median progression-free survival was 5.9 months, and overall survival was 9.2 months. Patients with disease that responded to the thalidomide-based regimen had better progression-free survival compared to those who did not (median, 8.8 vs. 2.5 months; P = .008). The most common adverse events were anemia (51%) for hematologic toxicities and peripheral neuropathy (30%) for non-hematologic toxicities. Conclusion: Thalidomide-based regimens are potential salvage treatment options for patients with RRMM, even those with disease with prior resistance to IMiDs. (C) 2019 Elsevier Inc. All rights reserved.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
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