Integrating novel agents into multiple myeloma treatment - Current status in Switzerland and treatment recommendations

Swiss Medical Weekly

Volumn 140, Issue SEPTEMBER, 2010, Pages

  Taverna, Christian ^a   Bargetzi, Mario ^b   Betticher, Daniel ^c   Gmür, Jürg ^d   Gregor, Michael ^e   Heim, Dominik ^f   Hess, Urs ^g   Ketterer, Nicolas ^h   Lerchi, Erika ⁱ   Matthes, Thomas ^j   Mey, Ulrich ^k   Pabst, Thomas ^m   Renner, Christoph ^l  

^a Kantonsspital Muensterlingen   (Switzerland)

^b CANTONAL HOSPITAL AARAU   (Switzerland)

^c Hopital Cantonal de Fribourg   (Switzerland)

^d Hirslanden Hospital Zurich   (Switzerland)

^e LUZERNER KANTONSSPITAL   (Switzerland)

^f UNIVERSITY HOSPITAL BASEL   (Switzerland)

^g CANTONAL HOSPITAL ST GALLEN   (Switzerland)

^h LAUSANNE UNIVERSITY HOSPITAL   (Switzerland)

ⁱ OSPEDALE SAN GIOVANNI   (Switzerland)

^j Cliniques HUG   (Switzerland)

^k KANTONSSPITAL GRAUBÜNDEN   (Switzerland)

^l Neurologische Poliklinik USZ   (Switzerland)

^m NONE

more..

Author keywords

Bone marrow transplant; Bortezomib; Elderly; Lenalidomide; Multiple myeloma; Relapsed refractory; Thalidomide

Indexed keywords

ACETYLSALICYLIC ACID; BISPHOSPHONIC ACID DERIVATIVE; BORTEZOMIB; CYCLOPHOSPHAMIDE; DEXAMETHASONE; DOXORUBICIN; LENALIDOMIDE; MELPHALAN; STEROID; THALIDOMIDE; VINCRISTINE;

AMYLOIDOSIS; AUTOLOGOUS STEM CELL TRANSPLANTATION; CANCER CHEMOTHERAPY; CLINICAL PRACTICE; CLINICAL TRIAL (TOPIC); COMORBIDITY; CYTOGENETICS; DIABETES MELLITUS; DRUG DOSE ESCALATION; DRUG DOSE INCREASE; DRUG DOSE REDUCTION; DRUG MEGADOSE; DRUG WITHDRAWAL; FRAIL ELDERLY; HERPES ZOSTER; HUMAN; HYPERCALCEMIA; HYPERKALEMIA; KIDNEY DISEASE; KIDNEY FAILURE; LOW DRUG DOSE; MULTIPLE CYCLE TREATMENT; MULTIPLE MYELOMA; NEUTROPENIA; PERIPHERAL NEUROPATHY; PHASE 3 CLINICAL TRIAL (TOPIC); REVIEW; STEM CELL MOBILIZATION; SWITZERLAND; THROMBOCYTOPENIA; THROMBOEMBOLISM; TREATMENT OUTCOME;

EID: 84855978563     PISSN: 14247860     EISSN: None     Source Type: Journal    
DOI: 10.4414/smw.2010.13054     Document Type: Review

References (94)

1. Kumar S, Rajkumar SV, Dispenzieri A, et al. Improved survival in multiple myeloma and the impact of novel therapies. Blood. 2008;111:2516-20.
2. Ludwig H, Beksac M, Bladé J, et al. Current multiple myeloma treatment strategies with novel agents: a European perspective. Oncologist. 2010;15:6-25.
3. Mateos MV, López-Corral L, Hernández MT, et al. Multicenter, randomized, open-label, phase III trial of lenalidomide- dexamethasone (Len/dex) vs therapeutic abstention in smoldering multiple myeloma at high risk of progression to symptomatic MM: results of the first interim analysis. Blood. 2009;114 (Abstract 614).
4. Kyle RA, Rajkumar SV. Criteria for diagnosis, staging, risk stratification and response assessment of multiple myeloma. Leukemia. 2009;23:3-9.
5. Taverna C. Multiple Myeloma - erkennen und behandeln. UNI-MED SCIENCE 2009.
6. Harousseau JL, Dreyling M. Multiple myeloma: ESMO Clinical Recommendations for diagnosis, treatment and follow-up. Ann Oncol. 2009;20(Suppl 4):97-9.
7. Blade J, Samson D, Reece D, et al. Criteria for evaluating disease response and progression in patients with multiple myeloma treated by high-dose therapy and haemopoietic stem cell transplantation. Myeloma Subcommittee of the EBMT. European Group for Blood and Marrow Transplant. Br J Haematol. 1998;102:1115-23. (Pubitemid 28435189)
8. Durie BGM, Harousseau J-L, Miguel JS, et al. International uniform response criteria for multiple myeloma. Leukemia. 2006;20:1467-73. (Pubitemid 44264086)
9. van de Velde HJ, Liu X, Chen G, et al. Complete response correlates with long-term survival and progression-free survival in high-dose therapy in multiple myeloma. Haematologica. 2007;92:1399-406. (Pubitemid 350144158)
10. Harousseau JL, Attal M, Avet-Loiseau H. The role of complete response in multiple myeloma. Blood. 2009;114:3139-46.
11. Kyle RA, Leong T, Li S, et al. Complete response in multiple myeloma: clinical trial E9486, an Eastern Cooperative Oncology Group study not involving stem cell transplantation. Cancer. 2006;106:1958-66. (Pubitemid 43673211)
12. Harousseau JL, Palumbo A, Richardson P, et al. Superior Outcomes Associated with Complete Response: Analysis of the Phase III VISTA Study of Bortezomib Plus Melphalan-Prednisone Versus Melphalan-Prednisone. Blood. 2008;112 (Abstract 2778).
13. Cavo M, Zamagni E, Tosi P, et al. Superiority of thalidomide and dexamethasone over vincristine-doxorubicindexamethasone (VAD) as primary therapy in preparation for autologous transplantation for multiple myeloma. Blood. 2005;106:35-9. (Pubitemid 40967171)
14. Macro M, Divine M, Uzunhan Y, et al. Dexamethasone + thalidomide (dex/thal) compared to VAD as a pre-transplant treatment in newly diagnosed multiple myeloma (MM): a randomized trial. Blood. 2006;108:22a (Abstract 57).
15. Zamagni E, Testoni N, Terragna C, et al. Incorporation of Thalidomide- Dexamethasone (Thal-Dex) into up-Front Double Autologous Stem- Cell Transplantation (ASCT) for multiple Myeloma: Final analysis of phase II "Bologna 2002" Study. Blood. 2009;114 (Abstract 349).
16. Harousseau JL, et al. VELCADE/dexamethasone (Vel/D) versus VAD as induction treatment prior to autologous stem cell transplantion (ASCT) in newly diagnosed multiple myeloma (MM): updated results of the IFM 2005/01 trial. ASH/ASCO symposium during ASH 2008.
17. Rajkumar SV, Jacobus S, Callander NS, et al. Lenalidomide plus highdose dexamethasone versus lenalidomide plus low-dose dexamethasone as initial therapy for newly diagnosed multiple myeloma: an open-label randomised controlled trial. Lancet Oncol. 2010;11:29-37.
18. Rajkumar SV, Jacobus S, Callander N, et al. Randomized trial of lenalidomide plus high-dose dexamethasone versus lenalidomide plus low-dose dexamethasone in newly diagnosed myeloma (E4A03), a trial coordinated by the Eastern Cooperative Oncology Group: Analysis of response, survival, and outcome with primary therapy and with stem cell transplantation. ASH/ASCO symposium during ASH 2008.
19. Bargetzi MJ, Passweg J, Baertschi E, et al. Mobilization of peripheral blood progenitor cells with vinorelbine and granulocyte colony-stimulating factor in multiple myeloma patients is reliable and cost effective. Bone Marrow Transplant. 2003;31:99-103. (Pubitemid 36240500)
20. Attal M, Harousseau JL, Facon T, et al. Single versus double autologous stem-cell transplantation for multiple myeloma. N Engl J Med. 2003;349:2495-502. (Pubitemid 38010075)
21. Cavo M, Tosi P, Zamagni E, et al. Prospective, randomized study of single compared with double autologous stem-cell transplantation for multiple myeloma: Bologna 96 clinical study. J Clin Oncol. 2007;25:2434-41. (Pubitemid 46999214)
22. Morgan GJ, Jackson GH, Davies FE, et al. Maintenance Thalidomide May Improve Progression Free but Not Overall Survival; Results from the Myeloma IX Maintenance Randomisation. Blood. 2008;112 (Abstract 656).
23. Attal M, Harousseau JL, Leyvraz S, et al. Maintenance therapy with thalidomide improves survival in patients with multiple myeloma. Blood. 2006;108:3289-94.
24. Cavo M, Tacchetti P, Patriarca F, et al. Superior Complete Response Rate and Progression-Free Survival after Autologous Transplantation with up-Front Velcade-Thalidomide-Dexamethasone Compared with Thalidomide-Dexamethasone in Newly Diagnosed Multiple Myeloma. Blood. 2008;112 (Abstract 158).
25. Lokhorst H, van der Holt B, Zweegman S, et al. HOVON-50 Final Analysis of Thalidomide Combined with Adriamycine, Dexamethasone (AD) and High Dose Melphalan (HDM). Clin Lymphoma Myeloma. 2009;9 (Suppl.1) (Abstract 46).
26. Morgan GJ, Davies FE, Owen RG et al. Thalidomide Combinations Improve Response Rates; Results from the MRC IX Study. Blood. 2007;110 (Abstract 3593).
27. Knop S, Liebisch P, Wandt H et al. Bortezomib, IV cyclophosphamide, and dexamethasone (VelCD) as induction therapy in newly diagnosed multiple myeloma: Results of an interim analysis of the German DSMM Xia trial. J Clin Oncol. 2009;27(18 suppl) (Abstract 8516).
28. Sonneveld P, van der Holt B, Schmidt-Wolf IGH et al. First Analysis of HOVON-65/GMMG-HD4 Randomized Phase III Trial Comparing Bortezomib, Adriamycine, Dexamethasone (PAD) vs VAD as Induction Treatment Prior to High Dose Melphalan (HDM) in Patients with Newly Diagnosed Multiple Myeloma (MM). Haematologica 2009;94(2 suppl) (Abstract 473).
29. Richardson P, Lonial S, Jakubowiak A, et al. Lenalidomide, bortezomib, and dexamethasone in patients with newly diagnosed multiple myeloma: encouraging efficacy in high risk groups with updated results of a phase I/II Study. Blood. 2008;112 (Abstract 92).
30. Garban F, Attal M, Michallet M, et al. Prospective comparison of autologous stem cell transplantation followed by dose-reduced allograft (IFM99-03 trial) with tandem autologous stem cell transplantation (IFM99-04 trial) in high-risk de novo multiple myeloma. Blood. 2006;107:3474-80.
31. Bruno B, Rotta M, Patriarca F, et al. A comparison of allografting with autografting for newly diagnosed myeloma. N Engl J Med. 2007;356:1110-20. (Pubitemid 46425595)
32. Bruno B, Rotta M, Patriarca F, et al. Nonmyeloablative allografting for newly diagnosed multiple myeloma: the experience of the Gruppo Italiano Trapianti di Midollo. Blood. 2009;113:3375-82.
33. Gahrton G, Bjorkstrand B, Iacobelli S, et al. Tandem Autologous (ASCT)/ Allogeneic Reduced Intensity Conditioning Transplantation (RIC) with Identical Sibling Donor Versus ASCT in Previously Untreated Multiple Myeloma (MM): Long Term Follow up of a Prospective Controlled Trial by the EBMT. Blood. 2009;114 (Abstract 52).
34. Facon T, Mary JY, Hulin C, et al. Melphalan and prednisone plus thalidomide versus melphalan and prednisone alone or reduced-intensity autologous stem cell transplantation in elderly patients with multiple myeloma (IFM 99-06): a randomised trial. Lancet. 2007;370:1209-18. (Pubitemid 47516593)
35. Hulin C, Facon T, Rodon P, et al. Efficacy of Melphalan and Prednisone Plus Thalidomide in Patients Older Than 75 Years With Newly Diagnosed Multiple Myeloma: IFM 01/01 Trial. J Clin Oncol. 2009;27:3664-70.
36. Palumbo A, Bringhen S, Liberati AM, et al. Oral melphalan, prednisone, and thalidomide in elderly patients with multiple myeloma: updated results of a randomized, controlled trial. Blood. 2008;112:3107-14.
37. Gulbrandsen N, Waage A, Gimsing P, et al. A randomised placebo controlled study with melphalan/prednisone versus melphalan/prednisone/ thalidomide: quality of life and toxicity. Haematologica. 2008;93 (Abstract 209).
38. Wijermans PW, Zweegman S, van Marwijk Kooy M, et al. MP versus MPT in elderly myeloma patients: the final outcome of the HOVON-49 study. Clin Lymphoma Myeloma. 2009;9(Suppl.1) (Abstract 116).
39. San Miguel J, Schlag R, Khuageva N, et al. Bortezomib plus Melphalan and Prednisone for Initial Treatment of Multiple Myeloma. N Engl J Med. 2008;359:906-17.
40. San Miguel J, Schlag R, Khuageva N, et al. Updated follow-up and results of subsequent therapy in the phase III VISTA trial: Bortezomib + Melphalan-Prednisone versus Melphalan-Prednisone in newly diagnosed multiple myeloma. Blood. 2008;112 (Abstract 650).
41. Kropff M, Richardson PG, Schlag R, et al. Similar benefit in patients ≥75 or <75 years with VMP versus MP in front-line MM and bortezomib versus dexamethasone in relapsed MM. Clin Lymphoma Myeloma. 2009;9 (Suppl.1) (Abstract 84).
42. Dimopoulos MA, Richardson P, Schlag R, et al. Bortezomib-Melphalan- Prednisone (VMP) in Newly Diagnosed Multiple Myeloma Patients with Impaired Renal Function: Cohort Analysis of the Phase III VISTA Study. Clin Lymphoma Myeloma. 2009;9 (Suppl.1) (Abstract 166).
43. Palumbo A, Falco P, Falcone A et al. Melphalan, Prednisone, and Lenalidomide for Newly Diagnosed Myeloma: Kinetics of Neutropenia and Thrombocytopenia and Time-to-Event Results. Clin Lymphoma Myeloma. 2009;9:145-50.
44. Richardson PG, Sonneveld P, Schuster M, et al. Extended follow-up of a phase 3 trial in relapsed multiple myeloma: final time-to-event results of the APEX trial. Blood. 2007;110:3557-60. (Pubitemid 350159621)
45. Cuesta A, Galera P, Garcia-Sanchez R, et al. Bortezomib plus dexamethasone in relapsed/refractory multiple myeloma. Evaluation of the efficacy and toxicity. Blood. 2008;112 (Abstract 5180).
46. Orlowski RZ, Nagler A, Sonneveld P, et al. Randomized phase III study of pegylated liposomal doxorubicin plus bortezomib compared with bortezomib alone in relapsed or refractory multiple myeloma: combination therapy improves time to progression. J Clin Oncol. 2007;25:3892-901. (Pubitemid 47477266)
47. Sonneveld P, Hajek R, Nagler A, et al. Combined Pegylated Liposomal Doxorubicin and Bortezomib is highly effective in patients with recurrent or refractory multiple myeloma who received prior Thalidomide/ Lenalidomide therapy. Cancer. 2008;112:1529-37. (Pubitemid 351441165)
48. Dimopoulos M, Spencer A, Attal M, et al. Lenalidomide plus Dexamethasone for Relapsed or Refractory Multiple Myeloma. N Engl J Med. 2007;357:2123-32. (Pubitemid 350146107)
49. Dimopoulos MA, Chen C, Spencer A, et al. Long-term follow-up on overall survival from the MM-009 and MM-010 phase III trials of lenalidomide plus dexamethasone in patients with relapsed or refractory multiple myeloma. Leukemia. 2009;23:2147-52.
50. Weber DM, Chen C, Niesvizky R, et al. Lenalidomide plus Dexamethasone for Relapsed Multiple Myeloma in North America. N Engl J Med. 2007;357:2133-42. (Pubitemid 350146108)
51. Wang M, Dimopoulos MA, Chen C, et al. Lenalidomide plus dexamethasone is more effective than dexamethasone alone in patients with relapsed or refractory multiple myeloma regardless of prior thalidomide exposure. Blood. 2008;112:4445-51.
52. Knop S, Gerecke C, Liebisch P, et al. Lenalidomide, adriamycin, and dexamethasone (RAD) in patients with relapsed and refractory multiple myeloma: a report from the German Myeloma Study Group DSMM (Deutsche Studiengruppe Multiples Myelom). Blood. 2009;113:4137-43.
53. Anderson KC, Jagannath S, Jakubowiak A, et al. Lenalidomide, bortezomib, and dexamethasone in relapsed/refractory multiple myeloma (MM): Encouraging outcomes and tolerability in a phase II study. J Clin Oncol. 2009;27:15s (Abstract 8536).
54. Hrusovsky I, Emmerich B, von Rohr A, et al. Bortezomib retreatment in relapsed multiple myeloma (MM): results from a binational, multicenter retrospective survey. Blood. 2008;112 (Abstract 2775).
55. Petrucci MT, Blau IW, Corradini P, et al. Efficacy and Safety of Re- Treatment with Bortezomib (Velcade©) in Patients with Multiple Myeloma: Results from a Prospective International Phase II Trial. Blood. 2008;112 (Abstract 3690).
56. Richardson PG, Barlogie B, Berenson J, et al. A phase 2 study of bortezomib in relapsed, refractory myeloma. N Engl J Med. 2003;348:2609-17. (Pubitemid 36741588)
57. Jagannath S, Barlogie B, Berenson JR, et al. Updated survival analyses after prolonged follow-up of the phase 2, multicenter CREST study of bortezomib in relapsed or refractory multiple myeloma. Br J Haematol. 2008;143:537-40.
58. Tosi P, Zamagni E, Cellini C, et al. Thalidomide alone or in combination with dexamethasone in patients with advanced, relapsed or refractory multiple myeloma and renal failure. Eur J Haematol. 2004;73:98-103. (Pubitemid 38980109)
59. Harris E, Behrens J, Samson D, et al. Use of thalidomide in patients with myeloma and renal failure may be associated with unexplained hyperkalaemia. Br J Haematol. 2003;122:160-1.
60. Fakhouri F, Guerraoui H, Presne C, et al. Thalidomide in patients with multiple myeloma and renal failure. Br J Haematol. 2004;125:96-7. (Pubitemid 38453289)
61. Weber DM, Spencer A, Wang M, et al. The efficacy and safety of lenalidomide plus dexamethasone in relapsed or refractory multiple myeloma patients with impaired renal function. J Clin Oncol. 2008;26 (Abstract 8542).
62. Revlimid, www.kompendium.ch
63. Dimopoulos MA, Roussou M, Kastritis E, et al. Reversibility of Renal Impairment of Multiple Myeloma Patients Treated with Bortezomib- Based Regimens: Identification of Predictive Factors. Blood. 2008;112 (Abstract 1725).
64. Ludwig H, Adam Z, Greil R, et al. Reversal of acute renal impairment by Bortezomib-Doxorubicin-Dexamethasone (BDD) in Multiple Myeloma (MM). Results from a Phase II Study. Haematologica. 2009;94(s2):154 (Abstract 385).
65. Velcade, www.kompendium.ch
66. Mulkerin D, Remick S, Takimoto C, Ivy P, Karol M, Eton O. Safety, tolerability, and pharmacology of bortezomib in cancer patients with renal failure requiring dialysis: results from a prospective phase 1 study. Blood. 2007;110 (Abstract 3477).
67. San-Miguel JF, Richardson PG, Sonneveld P, et al. Efficacy and safety of bortezomib in patients with renal impairment: results from the APEX phase 3 study. Leukemia. 2008;22:842-9. (Pubitemid 351552634)
68. Avet-Loiseau H, Soulier J, Fermand JP, et al. Impact of Chromosomal Abnormalities Del(13), T(4;14), and Del(17p) and Prior Treatment on Outcomes in Patients with Relapsed or Refractory Multiple Myeloma Treated with Lenalidomide. Blood. 2008;112 (Abstract 3685).
69. Kapoor P, Kumar S, Fonseca R, et al. Impact of risk stratification on outcome among patients with multiple myeloma receiving initial therapy with lenalidomide and dexamethasone. Blood. 2009;114:518-21.
70. Reece D, Song KW, Fu T, Roland B, et al. Influence of cytogenetics in patients with relapsed or refractory multiple myeloma treated with lenalidomide plus dexamethasone: adverse effect of deletion 17p13. Blood. 2009;114:522-5.
71. Richardson PG, Sonneveld P, Schuster MW, et al. Bortezomib or highdose dexamethasone for relapsed multiple myeloma. N Engl J Med. 2005;352:2487-98. (Pubitemid 41007864)
72. Mateos MV, Richardson PG, Schlag R, et al. Peripheral neuropathy with VMP in the phase III VISTA study resolves in the majority of patients and shows a rate plateau. Clin Lymphoma Myeloma. 2009;9 (Suppl.1) (Abstract 172).
73. Mateos MV, Oriol A, Martinez J, et al. Bortezomib (Velcade)/ melphalan/prednisone (VMP) versus Velcade/thalidomide/prednisonse (VTP) in elderly untreated multiple myeloma (MM) patients. Haematologica. 2009;94(s2):190 (Abstract 471).
74. Palumbo A, Bringhen S, Rossi D, et al. Bortezomib, melphalan, prednisone and thalidomide (VMPT) versus bortezomib, melphalan and prednisone (VMP) in elderly newly diagnosed myeloma patients: a prospective, randomized phase III study. Haematologica. 2009;94(s2):190 (Abstract 472).
75. Mileshkin L, Stark R, Day B, et al. Development of neuropathy in patients with myeloma treated with thalidomide: patterns of occurrence and the role of electrophysiologic monitoring. J Clin Oncol. 2006;24:4507-14. (Pubitemid 46630990)
76. Ghobrial IM, Rajkumar SV. Management of Thalidomide Toxicity. J Support Oncol. 2003;1:194-205.
77. Palumbo A, Rajkumar SV, Dimopoulos MA, et al. Prevention of thalidomide- and lenalidomide-associated thrombosis in myeloma. Leukemia. 2008;22:414-23. (Pubitemid 351255436)
78. Richardson P, Jagannath S, Hussein M, et al. Safety and efficacy of single-agent lenalidomide in patients with relapsed and refractory multiple myeloma. Blood. 2009;114:772-8.
79. Pour L, Adam Z, Buresova L, et al. Varicella-zoster virus pro-phylaxis with low-dose acyclovir in patients with multiple myeloma treated with bortezomib. Clin Lymphoma Myeloma. 2009;9:151-3.
80. Vickrey E, Allen S, Mehta J et al. Acyclovir to prevent reactivation of varicella zoster virus (herpes zoster) in multiple myeloma patients receiving bortezomib therapy. Cancer. 2009;115:229-32.
81. Valtrex, www.kompendium.ch
82. www.swissmedic.ch
83. Anderson KC, Alsina M, Bensinger W, et al. Multiple myeloma: clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2007;5:118-47. (Pubitemid 46423053)
84. Barosi G, Boccadoro M, Cavo M, et al. Management of multiple myeloma and related-disorders: guidelines from the Italian Society of Hematology (SIE), Italian Society of Experimental Hematology (SIES) and Italian Group for Bone Marrow Transplantation (GITMO). Haematologica. 2004;89:717-41. (Pubitemid 38828479)
85. Harousseau JL, Moreau P. Autologous hematopoietic stem-cell transplantation for multiple myeloma. N Engl J Med. 2009;360:2645-54.
86. Palumbo A, Sezer O, Kyle R, et al. International Myeloma Working Group guidelines for the management of multiple myeloma patients ineligible for standard high-dose chemotherapy with autologous stem cell transplantation. Leukemia. 2009;23:1716-30.
87. Patriarca F, Petrucci MT, Bringhen S, et al. Considerations in the treatment of multiple myeloma: a consensus statement from Italian experts. Eur J Haematol. 2009;82:93-105.
88. San Miguel JF. Relapse/Refractory myeloma patient: potential treatment guidelines. J Clin Oncol. 2009;27:5676-7.
89. Smith A, Wisloff F, Samson D. Guidelines on the diagnosis and management of multiple myeloma. Br J Haematol. 2005;132:410-51.
90. Durie BG, Salmon SE. A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival. Cancer. 1975;36:842-54.
91. Greipp PR, San Miguel J, Durie BG, et al. International staging system for multiple myeloma. J Clin Oncol. 2005;23:3412-20.
92. Mikhael JR, Belch AR, Prince HM et al. High response rate to bortezomib with or without dexamethasone in patients with relapsed or refractory multiple myeloma: results of a global phase 3b expanded access program Br J Haematol. 2009;144:169-75.
93. Palumbo A, Gay F, Bringhen S, et al. Bortezomib, doxorubicin and dexamethasone in advanced multiple myeloma. Ann Oncol. 2008;19:1160-5. (Pubitemid 351796343)
94. von Lilienfeld-Toal M, Hahn-Ast C, Furkert K, et al. A systematic review of phase II trials of thalidomide/dexamethasone combination therapy in patients with relapsed or refractory multiple myeloma. Eur J Haematol. 2008;81:247-52.