A modified regimen of pegylated liposomal doxorubicin, bortezomib and dexamethasone (DVD) is effective and well tolerated for previously untreated multiple myeloma patients

SummaryThe combination of pegylated liposomal doxorubicin (PLD), bortezomib anddexamethasone has shown efficacy in the treatment of multiple myeloma(MM) patients. Our earlier retrospective study suggested that modification ofthe doses, schedules and route of administration of these drugs appears toreduce toxicity without compromising anti-MM activity. As a result, weevaluated this modified drug combination in the frontline setting in aprospective multicentre phase II trial. Thirty-five previously untreated MMpatients were enrolled. Dexamethasone IV 40 mg, bortezomib 1 mg/m 2 andPLD 5 mg/m 2 were administered on days 1, 4, 8 and 11 of a 4-week cycle.Patients were treated to their maximum response plus two additional cycles.The treatment regimen was discontinued after a maximum of eight cycles.Our modified schedule and dosing regimen achieved a high overall responserate of 86%, while showing a marked decrease in the incidence and severityof peripheral neuropathy, palmar-plantar erythrodysesthesia and myelo-suppression compared to the standard dosing on a 3-week cycle using thesedrugs. This modified regimen of dexamethasone, bortezomib and PLD showsimproved tolerability and safety while maintaining a high response rate whencompared to standard treatment with these agents in the frontline setting.Keywords: multiple myeloma, dexamethasone, bortezomib, pegylated lipo-somal doxorubicin.