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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.”
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