A systematic review of phase II trials of thalidomide/dexamethasone combination therapy in patients with relapsed or refractory multiple myeloma
2008

Thalidomide and Dexamethasone for Multiple Myeloma

Sample size: 451 publication Evidence: moderate

Author Information

Author(s): Marie von Lilienfeld-Toal, Corinna Hahn-Ast, Kerstin Furkert, Florian Hoffmann, Ralph Naumann, Ralf Bargou, Gordon Cook, Axel Glasmacher

Primary Institution: Medizinische Klinik und Poliklinik III, Rheinische Friedrich Wilhelms Universität Bonn, Germany

Hypothesis

Does the combination of thalidomide and dexamethasone improve response rates and increase adverse events in patients with relapsed or refractory multiple myeloma?

Conclusion

The combination of thalidomide and dexamethasone improves response rates in relapsed/refractory multiple myeloma without significantly increasing toxicity.

Supporting Evidence

  • The response rate for thalidomide monotherapy is 30%, while the combination therapy shows a response rate of 46%.
  • Therapy-related toxicity was comparable to thalidomide monotherapy.
  • Common adverse events included somnolence (26%), constipation (37%), and peripheral neuropathy (27%).
  • Venous thromboembolism occurred more frequently with the combination therapy at a rate of 5%.

Takeaway

This study shows that using thalidomide with another medicine called dexamethasone helps more people with a type of blood cancer called multiple myeloma feel better, and it doesn't make them much sicker.

Methodology

A systematic review of 12 studies evaluating the efficacy and toxicity of thalidomide/dexamethasone in relapsed/refractory multiple myeloma.

Potential Biases

Potential reporting bias in adverse events due to inconsistencies in study reporting.

Limitations

The studies included were mostly unicentric phase II studies and none were randomized controlled trials.

Participant Demographics

Median age of participants was 63 years, with most having relapsed disease.

Statistical Information

P-Value

0.016

Confidence Interval

95% CI 42–51%

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1111/j.1600-0609.2008.01121.x

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