Controversies regarding the use of dexamethasone in patients with multiple myeloma
Rajkumar, S.V.
Clinical Advances in Hematology and Oncology H&o 6(2): 103; 141
2008
ISSN/ISBN: 1543-0790 PMID: 18347560 Document Number: 11780
In patients with relapsed/refractory multiple myeloma, I do not believe the results from ECOG E4A03 fully apply. There may be patients for whom highdose dexamethasone is needed. The regimen currently approved by the US Food and Drug Administration for relapsed/refractory multiple myeloma is lenalidomide and high-dose dexamethasone. I have seen a number of patients respond to higher doses of steroids when lower doses are no longer effective. High-dose dexamethasone alone or in combination continues to have a potential role in the relapsed/refractory setting. Additionally, there are several new drugs in development for patients with relapsed/refractory disease, which will improve the available treatment options. One such agent is the proteasome inhibitor carfilzomib (Proteolix), which has shown promising activity already. Another is CC4047 (Actimid, Celgene), another immunomodulatory thalidomide analog, which has shown activity in clinical trials.
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