A Phase II Trial of VAD ( Vincristine , Doxorubicin and Dexamethasone ) Chemotherapy for Previously Untreated Multiple Myeloma.
- Author:
Seong Whan KIM
1
;
Baek Yeol RYOO
;
Tae You KIM
;
Young Hyuck IM
;
Yeon Hee PARK
;
Bong Seog KIM
;
Byung Kook CHOI
;
Kyung Hyun KIM
;
Yoon Koo KANG
Author Information
1. Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Multiple myeloma;
VAD(vincristine, doxorubicin, dexamethasone) chemotherapy
- MeSH:
Dexamethasone*;
Disease-Free Survival;
Doxorubicin*;
Drug Therapy*;
Humans;
Leukopenia;
Multiple Myeloma*;
Plasma Cells;
Remission Induction;
Stomatitis;
Vincristine*
- From:Korean Journal of Medicine
1999;56(1):75-84
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: The combination of vincristine and doxorubicin by continuous infusion was reported to reduce tumor mass more rapidly than standard regimens, which maybe a result of effect on more slowly proliferating plasma cells. We conducted a phase II study to determine the activity and safety of VAD (vincristine, doxorubicin, dexamethasone) chemotherapy, in which vincristine and doxorubicin are administered as a continuous infusion, for previously untreated multiple myeloma. METHODS: VAD chemotherapy (vincristine 0.4 mg/day 24 hour-continuous infusion, days 1~4; doxorubicin 9 mg/m2/day 24 hour-continuous infusion, days 1~4; dexamethasone 40 mg/day p.o. days 1~4) was given to eligible patients every 4 weeks and we assessed response and toxicity of the regimen. RESULTS: Between January 1991 and March 1997, total 25 patients entered this trial and 22 were evaluable. The complete response rate was 14%(3/22) and overall response rate was 59%(13/22, 95% C.I.: 38~80%). The time to response was 1.0~6.8(median 2.9) months. Progression free survival was 2~39+(median 11.5) months and the overall survival was 3+~42+(median 19.7) months. Toxicities of VAD regimen were leukopenia, infection, stomatitis and neurotoxicity, but there was no treatment-related death. CONCLUSION: VAD chemotherapy was tolerable, but not more active than the alkylating agent-based chemotherapy as a front-line treatment for the patients with multiple myeloma. But, because of its rapid response and relatively mild myelotoxicity, it could play a role for advanced or highly complicated disease and for remission induction before consolidation with high-dose chemotherapy.
