High Frequencies of Response After Limited Primary Therapy for Multiple Myeloma

BackgroundRecent bortezomib combinations have induced remission in approximately 90% of patients newly diagnosed, with moderate frequency of adverse effects.PatientsIn an attempt to reduce adverse effects, and to prepare qualified patients for early intensification, we assessed the antimyeloma effect and toxicity of 3 different bortezomib combinations in small numbers of patients.MethodsWith reduced doses and short durations of exposure, we combined bortezomib with (a) cyclophosphamide/dexamethasone, (b) lenalidomide/dexamethasone/liposomal doxorubicin, and (c) cyclophosphamide/dexamethasone/lenalidomide.ResultsResponse rates were high, with rare episodes of severe drug-related toxicity.ConclusionsFurther study of similar combinations of effective drugs given in limited doses and for short durations would be useful.