Thalidomide, clarithromycin, lenalidomide and dexamethasone therapy in newly diagnosed, symptomatic multiple myeloma.

Abstract

We studied T-BiRD (thalidomide [Thalomid(®)], clarithromycin [Biaxin(®)], lenalidomide [Revlimid(®)] and dexamethasone) in symptomatic, newly diagnosed multiple myeloma. In 28-day cycles, patients received dexamethasone 40 mg/day on days 1, 8, 15, 22, clarithromycin 500 mg twice daily on days 1-28; lenalidomide 25 mg/day on days 1-21; and thalidomide 100 mg/day (50 mg/day on days 1-7 of cycle 1 only) on days 1-28. Twenty-six patients received a median of 6 cycles (range 0-41). Overall response rate (ORR) was 80% for the group and 100% in 11 patients who underwent autologous stem cell transplantation as part of first-line therapy. The 4-year overall survival rate was 74.9%, and the median progression-free survival was 35.6 months. Eight patients discontinued due to regimen toxicity. Grade 3 non hematologic toxicity affected 12 patients (46.2%). T-BiRD is a highly active regimen with potential toxicity limitations. ClinicalTrials.gov identifier: NCT00538733.

• Authors: Tomer M Mark, Isaac A Bowman, Adriana C Rossi, Manan Shah, Melissa Rodriguez, Ryann Quinn, Roger N Pearse, Faiza Zafar, Karen Pekle, David Jayabalan, Scott Ely, Morton Coleman, Selina Chen-Kiang, Ruben Niesvizky
• Journal: Leukemia & lymphoma (Leuk Lymphoma) Vol. 55 Issue 12 Pg. 2842-9 (Dec 2014) ISSN: 1029-2403 [Electronic] United States
• PMID: 24576165 (Publication Type: Clinical Trial, Phase II, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Thalidomide
• Dexamethasone
• Lenalidomide
• Clarithromycin

Topics

• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Clarithromycin (administration & dosage)
• Dexamethasone (administration & dosage)
• Female
• Follow-Up Studies
• Hematopoietic Stem Cell Transplantation
• Humans
• Lenalidomide
• Male
• Middle Aged
• Multiple Myeloma (diagnosis, mortality, therapy)
• Neoplasm Staging
• Thalidomide (administration & dosage, analogs & derivatives)
• Transplantation, Autologous
• Treatment Outcome