Thalidomide and Dexamethasone: A New Standard of Care for Initial Therapy in Multiple Myeloma

InthisissueoftheJournalofClinicalOncology,Rajkumaretal report on the results of a randomized phase III clinical trial of thalidomide plus dexamethasone compared to high-dose dexamethasone alone in newly diagnosed multiple myeloma. 1 In this study, coordinated by the Eastern Cooperative Oncology Group, 207 patients were randomly assigned to either thalidomide plus dexamethasoneorhigh-dosedexamethasonealone.Responserate, the primary end point, was significantly higher with thalidomide plus dexamethasone than single-agent high-dose dexamethasone (63% v 41%, respectively, P .002); however, this benefit was associated with important toxicities, including deep vein thrombosis (DVT) and treatment-related mortality, which were 5% and 4%, respectively. 1