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Trial backs low-dose dexamethasone

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Lower doses of dexamethasone are better than high doses when combined with lenalidomide to treat patients with newly diagnosed myeloma, according to a trial reported in The Lancet Oncology.

It shows that after one year, overall survival was 96% in the low-dose group compared with 87% in the high-dose group. As a result, high-dose patients were switched to low doses.

The report concludes: “This trial … shows that low-dose dexamethasone in conjunction with lenalidomide is an active regimen for newly diagnosed myeloma with acceptable toxicity and low early mortality.”

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The report is written by Professor Vincent Rajkumar and colleagues at the Mayo Clinic in the US on behalf of the Eastern Co-operative Oncology Group (ECOG).

High-dose patients with untreated, symptomatic myeloma received lenalidomide 25mg on days 1-21 plus dexamethasone 40mg on days 1-4, 9-12, and 17-20 of a 28-day cycle.

Low-dose patients received lenalidomide on the same schedule with dexamethasone 40mg on days 1, 8, 15, and 22 of a 28-day cycle.

Copyright Press Association 2009

The Lancet Oncology






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