Maintenance Therapy for Multiple Myeloma with Particular Emphasis on Thalidomide

Publisher： Karger

E-ISSN： 2296-5262|29|12|582-590

ISSN： 2296-5270

Source： Oncology Research and Treatment, Vol.29, Iss.12, 2006-12, pp. : 582-590

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Abstract

iTreatment standards are changing as a result of new findingsin the therapy of multiple myeloma. So far, prednisone,dexamethasone and interferon-a have mainly beenused as maintenance therapy after achieving remissionor stable disease. At present, thalidomide is being consideredas a new therapeutic option in several studies investigatingmaintenance therapy. As a result of the dosedependence of adverse effects such as neuropathy, constipation,sedation/vertigo and bradycardia, individualadjustment of the thalidomide dose is recommended.Only isolated cases of thrombosis occurred in the maintenancephase of therapy, and discontinuation of therapyis generally not necessary. While important study resultson the efficacy of thalidomide following conventionalchemotherapy are still awaited, it is the best documenteddrug so far for maintenance therapy following autologousstem cell transplantation. An upgrade of the responsewas seen in 22-73% of patients, as well as a significantprolongation of progression-free survival. For thefirst time, maintenance therapy with thalidomide showeda significant improvement in overall survival in a phaseIII study published recently. The tolerability of thalidomidecould be further improved by including the option ofintermittent administration of the drug.