Dr. Vad
01.09.2004, 19:30
For all colleagues onkogematologov to that it will be interesting/is useful given by info:
ASH: Clarithromycin Augments Response to Dexamethasone With or Without Thalidomide in Advanced Multiple Myeloma
Dexamethasone alone or in combination with low-dose thalidomide is an effective induction therapy for advanced multiple myeloma, and the addition of clarithromycin further improves prognosis, according to a randomised, prospective trial presented here December 9th at the American Society of Hematology 45th Annual Meeting.
The study included 23 patients with advanced myeloma, mostly stage III, and a median age of 62. Induction treatment consisted of pulsed dexamethasone (40 mg/day on Days 1-4, 9-12, and 17-20, every 30 days) with or without low-dose thalidomide (100-200 mg/day). Clarithromycin (550 mg orally twice daily) was also administered to patients who achieved a *lt; 50 % reduction in paraprotein after 8 weeks of treatment.
Overall, 83 % of patients responded to treatment at 8 weeks. Half of the patients showed at least a *gt; 50 % improvement, and 20 % showed a major response (*gt; 75 % improvement) in the intent-to-treat analysis. No patients showed a complete response.
Almost 40 % of patients did not achieve a partial response at 8 weeks, and were therefore given clarithromycin. The addition of clarithromycin resulted in further reduction of tumor mass. By 20 weeks, 55 % of these patients had responded.
More corticosteroid-related morbidities were reported with clarithromycin treatment, however. In addition, in the entire cohort, 1 case of grade 4 sepsis/pneumonia and 1 case of grade 3 diverticulitis occurred. Moreover, 4 patients experienced symptoms of deep venous thromboembolism: 3 in the dexamethasone group and 1 in the thalidomide plus dexamethasone group.
[Dexamethsone Alone, or in Combination with Low-Dose Thalidomide as Induction Therapy for Advanced Multiple Myeloma, and the Effect of the Addition of Clarithromycin (Biaxin (TM)) on Response Rate. Interim Results of a Prospective, Sequential, Randomized Trial. Abstract 832]
ASH: Clarithromycin Augments Response to Dexamethasone With or Without Thalidomide in Advanced Multiple Myeloma
Dexamethasone alone or in combination with low-dose thalidomide is an effective induction therapy for advanced multiple myeloma, and the addition of clarithromycin further improves prognosis, according to a randomised, prospective trial presented here December 9th at the American Society of Hematology 45th Annual Meeting.
The study included 23 patients with advanced myeloma, mostly stage III, and a median age of 62. Induction treatment consisted of pulsed dexamethasone (40 mg/day on Days 1-4, 9-12, and 17-20, every 30 days) with or without low-dose thalidomide (100-200 mg/day). Clarithromycin (550 mg orally twice daily) was also administered to patients who achieved a *lt; 50 % reduction in paraprotein after 8 weeks of treatment.
Overall, 83 % of patients responded to treatment at 8 weeks. Half of the patients showed at least a *gt; 50 % improvement, and 20 % showed a major response (*gt; 75 % improvement) in the intent-to-treat analysis. No patients showed a complete response.
Almost 40 % of patients did not achieve a partial response at 8 weeks, and were therefore given clarithromycin. The addition of clarithromycin resulted in further reduction of tumor mass. By 20 weeks, 55 % of these patients had responded.
More corticosteroid-related morbidities were reported with clarithromycin treatment, however. In addition, in the entire cohort, 1 case of grade 4 sepsis/pneumonia and 1 case of grade 3 diverticulitis occurred. Moreover, 4 patients experienced symptoms of deep venous thromboembolism: 3 in the dexamethasone group and 1 in the thalidomide plus dexamethasone group.
[Dexamethsone Alone, or in Combination with Low-Dose Thalidomide as Induction Therapy for Advanced Multiple Myeloma, and the Effect of the Addition of Clarithromycin (Biaxin (TM)) on Response Rate. Interim Results of a Prospective, Sequential, Randomized Trial. Abstract 832]