CCNU (lomustine), idarubicin and dexamethasone (CIDEX): an effective oral regimen for the treatment of refractory or relapsed myeloma

• Published in: British journal of haematology Vol. 109; no. 3; pp. 571 - 575
• Main Authors: Parameswaran, R., Giles, Chrissy, Boots, M., Littlewood, T. J., Mills, M. J., Kelsey, S. M., Samson, Diana
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.06.2000; Blackwell; Blackwell Publishing Ltd
• Subjects: Adult; Aged; Aged, 80 and over; Antibiotics, Antineoplastic - administration & dosage; Antibiotics, Antineoplastic - adverse effects; Antineoplastic agents; Antineoplastic Agents, Alkylating - administration & dosage; Antineoplastic Agents, Alkylating - adverse effects; Antineoplastic Agents, Hormonal - administration & dosage; Antineoplastic Agents, Hormonal - adverse effects; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; CCNU (lomustine); Chemotherapy; Dexamethasone - administration & dosage; Dexamethasone - adverse effects; Female; Hematology; Humans; idarubicin; Idarubicin - administration & dosage; Idarubicin - adverse effects; Lomustine - administration & dosage; Lomustine - adverse effects; Male; Medical sciences; Middle Aged; Multiple Myeloma - drug therapy; Multiple Myeloma - mortality; myeloma; Neutropenia - chemically induced; Pharmacology. Drug treatments; Pilot Projects; Recurrence; Survival Rate; Antineoplastic agent; Human; Immunopathology; Corticosteroid; Drug combination; Dexamethasone; Nitrosoureas; Malignant hemopathy; Myeloma; Alkylating agent; Chemotherapy; Treatment; Immunoglobulinopathy; Lymphoproliferative syndrome; Lomustine; Anthracyclins; Idarubicin; Negative therapeutic reaction
• ISSN: 0007-1048; 1365-2141
• DOI: 10.1046/j.1365-2141.2000.02082.x

We report the results of a non‐randomized pilot study of an oral regimen comprising CCNU (lomustine; 25 or 50 mg/m2 on day 1), idarubicin (4‐demethoxydaunorubicin) (10 mg/m2 on days 1–3) and dexamethasone (10 mg b.d. on days 1–4) in patients with relapsed or refractory myeloma. Treatment was given every 28 d for a maximum of six courses. Sixty patients were entered of whom 57 were evaluable. Overall response rate (partial or minor response) was 49% with 30% of patients achieving a partial response (50% tumour reduction). Response rates were higher in patients with untested relapse than in those with refractory disease (overall response rates 56% vs. 31%). The major toxicity was neutropenia and the regimen was otherwise well tolerated. The median survival from entry of all patients was 15 months, with 30% of patients alive at 2 years. This regimen represents a useful addition to available treatment options.