Klin Onkol 2002; 15(Suppl 2002): 42-43.
Summary: Introduction: Thalidomide is one of the new perspective drugs in the myeloma treatment due to its anti-angiogenic and immunomodulatory effects. Effectivity of thalidomide was proved in several trials in relapsed or refractory multiple myeloma (MM). The preliminary results and first experience with thalidomide treatment in Czech Republic are presented. Patients and Methods: Forty relapsed or refractory patients were enrolled in 3 centers. Starting dose of thalidomide ranged between 50 and 600 mg/day and 25-300 mg/day as maintenance therapy respectively. Combination of thalidomide with high dose of dexamethasone was used in 16 from 40 patients. Results: Overall response (including minimal response) was observed in 18 from 40 patients (45%, stable disease in 12 patients (30%), progression in 6 patients (15%) and in the 4 cases the response was not evaluated (3x short period of the treatment; 1 x early interruption of the treatment due to sever toxoalergic exanthema). The most frequent adverse events were obstipation, weakness, and neutropenia. One case of venooclusive disease was observed. Thalidomide treatment was stopped in 5 patients due to progression. Summary: We confirmed effectivity of thalidomide monotherapy or its combination with dexamethasone in relapsed and refractory patients with MM. Thalidomide, the perspective biological drug is evaluated as the first-line treatment in MM in the clinical trials focused on determination of the best tolerated dose including also aspects of the quality of life.
