## Abstract ## BACKGROUND Patients with multiple myeloma (MM) have increased bone marrow angiogenesis, a low plasma cell labeling index, and multidrug resistance (the primary cause of chemotherapy failure). MM patients receiving the vincristine, doxorubicin, and dexamethasone (VAD) regimen develop
Phase II study of CLAD (cyclophosphamide, liposomal doxorubicin and dexamethasone) in patients with advanced multiple myeloma and historical comparison to CAD (cyclophosphamide, doxorubicin and dexamethasone)
✍ Scribed by G. Hütter; H. Szélenyi; A. Schmittel; J. M. Siehl; E. Thiel; U. Keilholz
- Publisher
- John Wiley and Sons
- Year
- 2007
- Tongue
- English
- Weight
- 131 KB
- Volume
- 25
- Category
- Article
- ISSN
- 0278-0232
- DOI
- 10.1002/hon.821
No coin nor oath required. For personal study only.
✦ Synopsis
Abstract
The purpose of this study was to assess the efficacy and safety of pegylated liposomal doxorubicin in combination with cyclophosphamide and dexamethasone (CLAD). In this prospective open‐label phase II study, 60 patients with advanced multiple myeloma (MM) received three weekly cycles of CLAD, consisting of cyclophosphamide 200mg/m^2^ i.v. d1‐4, pegylated liposomal doxorubicin 20 mg/m^2^ i.v. d1 and dexamethasone 40 mg p.o. d1‐4 for a maximum of six cycles in absence of disease progression. Efficacy and toxicity was compared to our immediate historical cohort of 46 patients treated with cyclophosphamide, dexamethasone and conventional doxorubicin (CAD). A total of 239 cycles of CLAD and 209 cycles of CAD, respectively, were given. The objective response rate was 71% (CLAD) and 74% (CAD). Non‐cumulative hematological toxicity was predominant in both regimens. It was found that CLAD is an active and well‐tolerated treatment regimen for MM. Response rate is comparable to other anthracycline containing regimens like CAD with an advantage in hematological toxicity and lower infectious complications, and a presumed advantage of lower cardiotoxicity. Copyright © 2007 John Wiley & Sons, Ltd.
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## Abstract ## BACKGROUND Today, intensive therapy that includes high‐dose melphalan with autologous stem cell transplantation (ASCT) is considered standard therapy in younger patients with newly diagnosed myeloma. When the current trial was initiated, combined vincristine, doxorubicin, and dexame