Pegylated liposomal doxorubicin, vincristine, and reduced-dose dexamethasone as first-line therapy for multiple myeloma.

摘要: In patients with multiple myeloma (MM) who may ultimately receive active therapy, the combination of VAD (vincristine, doxorubicin, and dexamethasone) has been shown to be effective. However, use is complicated by inherent risks that result from central venous catheters, steroid toxicity, doxorubicin-associated adverse events such as cardiotoxicity alopecia. To address these issues, a phase II trial investigating vincristine, pegylated liposomal reduced-schedule oral dexamethasone in first-line treatment MM conducted. Patients symptomatic, newly diagnosed were treated intravenous (i.v.) doxorubicin 40 mg/m2 vincristine 2 mg on day 1, along mg/day given either i.v. or orally for 4 days, every weeks minimum 6 cycles. Responses reported 29 (88%), an additional 3 achieved stable disease. The median time maximal response was 5.8 months (range, 0.7-13.6 months), overall survival estimated 60 months. This regimen well tolerated, most common grade 3/4 included hand-foot syndrome (21%), neutropenia (30%), anemia mucositis (12%). Based results, vincristine/liposomal doxorubicin/dexamethasone appears effective tolerated MM.