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Review
. 2008 Oct;81(4):247-52.
doi: 10.1111/j.1600-0609.2008.01121.x. Epub 2008 Jul 10.

A Systematic Review of Phase II Trials of Thalidomide/Dexamethasone Combination Therapy in Patients With Relapsed or Refractory Multiple Myeloma

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Free PMC article
Review

A Systematic Review of Phase II Trials of Thalidomide/Dexamethasone Combination Therapy in Patients With Relapsed or Refractory Multiple Myeloma

Marie von Lilienfeld-Toal et al. Eur J Haematol. .
Free PMC article

Abstract

Thalidomide monotherapy in relapsed/refractory multiple myeloma (MM) has a response rate of 30%. The combination of thalidomide with dexamethasone (Thal/Dex) is expected to improve responses, but it is unknown if the combination increases the rate of adverse events. Here, we conducted a systematic review of studies evaluating Thal/Dex in relapsed/refractory MM. Twelve studies were included, comprising 451 patients. The response rate (CR and PR) was 46% (95% CI 42-51%). Therapy-related toxicity was comparable to thalidomide monotherapy and included somnolence (26%, 95% CI 22-31%), constipation (37%, 95% CI 32-42%) and peripheral neuropathy (27%, 95% CI 23-32%). Only venous thromboembolism appeared to occur more often with Thal/Dex (5%, 95% CI 3-8%). Thus, using Thal/Dex results in an improved response rate in relapsed/refractory MM, with a toxicity rate comparable to thalidomide monotherapy.

Figures

Figure 1
Figure 1
(A) Response rates of all included studies. Each dot indicates the response rate in one study, the size of the dot corresponds to the size of the study and the horizontal line depicts the 95% CI. The vertical line depicts the overall median and the diamond represents the 95% CI of the combined response rate. (B) Event-free survival of the studies that reported it (n = 6). Each dot indicates the median event-free survival in one study, the size of the dot corresponds to the size of the study. The line depicts the overall median.
Figure 2
Figure 2
Rate of venous thromboembolic events (VTE) in those studies which reported it (n = 7). Each dot indicates the rate of VTE in one study, the size of the dot corresponds to the size of the study. The line depicts the overall rate.

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