Selected regimens for relapsed/refractory myeloma.
| . | . | . | Response Rate . | . | ||
|---|---|---|---|---|---|---|
| Author/Year . | N . | Regimen . | CR . | PR . | MedianTTP . | Median PFS . |
| Abbreviations: B, bortezomib; CR, complete remission; CY, cyclophosphamide; Dex, dexamethasone; L, lenalidomide; NYR, not yet reached; P, prednisone; PFS, progression free survival; PR, partial remission; rel, relapsed; ref, refractory; thal, thalidomide; TTP, time to progression; VAD, vincristine, doxorubicin, dexamethasone. | ||||||
| Thalidomide +/− dexamethasone | ||||||
| Barlogie33 | 169 | Thal 200–800 mg/d | 2% | 28% | – | ~ 5 mo |
| Dimopoulos34 | 44 | Thal + Dex d 1–4, 9–12 & 17–20 x 1 (then d 1–4) q 28 d | – | 55% | > 10 mo | – |
| Oral cyclophosphamide-containing | ||||||
| De Weerdt35 | 42 | CY 100 mg/m2/d + P 10–20 mg/d | 2% | 38% | – | – |
| Stewart36 | 59 | CY 500 mg/wk P 50–100 mg q 2d | 0 | 41% | – | 18.6 mo |
| Garcia-Sanz37 | 71 | CY 50 mg/d + Dex d1–4 + Thal 200–800 mg/d q 21 d | 2% | 53% | – | NYR (53% at 24 mo) |
| Williams38 | 29 VAD rel | CY 500 mg d 1 ,8 & 15 + Thal 100–200 mg/d + | – | 83% | – | – |
| 17 rel | Dex d1–4 & 14–17 q 28d | – | 71% | – | – | |
| Hovenga39 | 38 | CY median dose 95 mg/d + Thal median dose 100 mg/d | 0 | 64% | – | 30 mo |
| Bortezomib +/− dexamethasone | ||||||
| Richardson6 | 202 | B 1.3 mg/m2 d1, 4, 8 & 11 +/− | 4% | 31% | 7 mo | – |
| Dex 20 mg d1–2, 4–5, 8–9 & 11–12 q 21 days | ||||||
| Richardson7 (phase III trial) | B 1.3 mg/m2 d1,4, 8 & 11 q 21d vs | 6% | 32% | 6.22 mo | – | |
| Dex 40 mg d1–4, 9–12 & 17–20 q 35 d | < 1% | 18% | 3.49 mo | – | ||
| Lenalidamide +/− dexamethasone | ||||||
| Richardson8 | 101 | L 15 mg BID vs 30 mg q d | 6% | 18% | – | – |
| L + Dex 40 mg d 1–4 & 14–17 | 0 | 33% | – | – | ||
| Weber40 (Phase III trial) | 171 | L 25 mg d1–21 + Dex 40 mg d1–4, 9–12 & 17–20 x 4 (then d 1–4) q 28d vs | 19% | 51% | – | NYR at 15mo |
| Dex same | 4% | 23% | – | 5 mo | ||
| . | . | . | Response Rate . | . | ||
|---|---|---|---|---|---|---|
| Author/Year . | N . | Regimen . | CR . | PR . | MedianTTP . | Median PFS . |
| Abbreviations: B, bortezomib; CR, complete remission; CY, cyclophosphamide; Dex, dexamethasone; L, lenalidomide; NYR, not yet reached; P, prednisone; PFS, progression free survival; PR, partial remission; rel, relapsed; ref, refractory; thal, thalidomide; TTP, time to progression; VAD, vincristine, doxorubicin, dexamethasone. | ||||||
| Thalidomide +/− dexamethasone | ||||||
| Barlogie33 | 169 | Thal 200–800 mg/d | 2% | 28% | – | ~ 5 mo |
| Dimopoulos34 | 44 | Thal + Dex d 1–4, 9–12 & 17–20 x 1 (then d 1–4) q 28 d | – | 55% | > 10 mo | – |
| Oral cyclophosphamide-containing | ||||||
| De Weerdt35 | 42 | CY 100 mg/m2/d + P 10–20 mg/d | 2% | 38% | – | – |
| Stewart36 | 59 | CY 500 mg/wk P 50–100 mg q 2d | 0 | 41% | – | 18.6 mo |
| Garcia-Sanz37 | 71 | CY 50 mg/d + Dex d1–4 + Thal 200–800 mg/d q 21 d | 2% | 53% | – | NYR (53% at 24 mo) |
| Williams38 | 29 VAD rel | CY 500 mg d 1 ,8 & 15 + Thal 100–200 mg/d + | – | 83% | – | – |
| 17 rel | Dex d1–4 & 14–17 q 28d | – | 71% | – | – | |
| Hovenga39 | 38 | CY median dose 95 mg/d + Thal median dose 100 mg/d | 0 | 64% | – | 30 mo |
| Bortezomib +/− dexamethasone | ||||||
| Richardson6 | 202 | B 1.3 mg/m2 d1, 4, 8 & 11 +/− | 4% | 31% | 7 mo | – |
| Dex 20 mg d1–2, 4–5, 8–9 & 11–12 q 21 days | ||||||
| Richardson7 (phase III trial) | B 1.3 mg/m2 d1,4, 8 & 11 q 21d vs | 6% | 32% | 6.22 mo | – | |
| Dex 40 mg d1–4, 9–12 & 17–20 q 35 d | < 1% | 18% | 3.49 mo | – | ||
| Lenalidamide +/− dexamethasone | ||||||
| Richardson8 | 101 | L 15 mg BID vs 30 mg q d | 6% | 18% | – | – |
| L + Dex 40 mg d 1–4 & 14–17 | 0 | 33% | – | – | ||
| Weber40 (Phase III trial) | 171 | L 25 mg d1–21 + Dex 40 mg d1–4, 9–12 & 17–20 x 4 (then d 1–4) q 28d vs | 19% | 51% | – | NYR at 15mo |
| Dex same | 4% | 23% | – | 5 mo | ||