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

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.
AuthorsTomer 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
JournalLeukemia & lymphoma (Leuk Lymphoma) Vol. 55 Issue 12 Pg. 2842-9 (Dec 2014) ISSN: 1029-2403 [Electronic] England
PMID24576165 (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
  • 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
  • Male
  • Middle Aged
  • Multiple Myeloma (diagnosis, mortality, therapy)
  • Neoplasm Staging
  • Thalidomide (administration & dosage, analogs & derivatives)
  • Transplantation, Autologous
  • Treatment Outcome

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