Effective response with bortezomib retreatment in relapsed multiple myeloma--a multicentre retrospective survey in Switzerland.

Previous studies have shown that retreatment of relapsed/refractory multiple myeloma (MM) with a second course of bortezomib therapy could be effective in heavily pre-treated patients. In this study, the results of a multicentre, retrospective survey were reported involving patients in Switzerland with MM who responded to initial bortezomib therapy; 43 patients were enrolled and 42 were evaluated for response. The overall response rate (complete response [CR] + near CR [nCR] + partial response [PR]) to bortezomib retreatment was 64.3%, and the clinical benefit rate (CR + nCR + PR + stable disease) for retreatment was 83%. The response rate to bortezomib retreatment in the subgroup with a first treatment-free interval (TFI) >6 months was higher than that in the subgroup with first TFI ≤6 months (74.1% vs. 46.7%) and lower in patients who received concomitant dexamethasone with bortezomib retreatment (57.1% vs. 78.6%). The median overall survival (OS) from first diagnosis of MM was 9.3 years, and after retreatment with bortezomib the median OS was 1.7 years. In total, 85.7% of patients who achieved CR or nCR with initial bortezomib treatment achieved CR or nCR with retreatment. Bortezomib as retreatment was well tolerated, and the safety profile was consistent with previous studies of bortezomib in relapsed MM. The most common adverse drug reaction attributed to bortezomib was peripheral neuropathy in 5 patients. In conclusion, bortezomib retreatment was a well-tolerated, effective therapeutic option for relapsed MM patients in the Swiss clinical setting who have previously responded to bortezomib, particularly for those who experienced an initial TFI of >6 months.

Pegylated liposomal doxorubicin (caelyx) in metastatic breast cancer: a community-based observation study.

OBJECTIVES: Pegylated liposomal doxorubicin (PLD) has improved therapy options significantly, as it causes less myelosuppression, nausea, vomiting, and alopecia than conventional doxorubicin, while maintaining efficacy. The goal of this survey was to determine whether the use of PLD in a community-based patient group is comparable regarding chemotherapeutic doses and side effects to preselected study patients. METHODS: 100 questionnaires were randomly sent to Swiss oncologists in private practices, general hospitals and university hospitals. RESULTS: The patient cohort was heterogeneous with respect to prior treatments. PLD was an active agent in metastatic breast cancer and was well tolerated by the majority of patients. The most common non-hematological side effects were hand-foot syndrome (HFS) and mucositis while only patients receiving a dose of 50 mg/m(2) (recommended dose) experienced grade 4 HFS. The reported mean dose of PLD was 38.5 mg/m(2). CONCLUSIONS: This community-based observational study supports previous reports indicating that PLD at a median dose of < or =40 mg/m(2) every 4 weeks is an active, well-tolerated agent in non-selected, pretreated patients with metastatic breast cancer.

Potential predictive patterns of minimal residual disease detected by immunohistochemistry on bone marrow biopsy specimens during a long-term follow-up in patients treated with cladribine for hairy cell leukemia.

CONTEXT: Minimal residual disease (MRD) in patients treated for hairy cell (HC) leukemia as assessed by immunohistochemistry has not been included routinely in evaluation of treatment results. OBJECTIVE: To assess the presence of persistent HCs after treatment, as detected by immunohistochemistry, and to evaluate the correlation between the level of MRD and clinical outcome. DESIGN: Percentages of DBA.44-positive HCs were assessed on 116 biopsy specimens from 17 patients. The patients had a median follow-up of 55.4 months. RESULTS: Minimal residual disease was seen in 3 patterns. Group 1 (7 patients) had MRD levels ranging from "rare scattered suspicious HCs" to less than 1%. The MRD levels were stable throughout follow-up, and all patients remained in complete remission. Group 2 (6 patients) had MRD levels ranging from 1% to 5%, and 3 patients were in complete remission at 77.9, 63.8, and 108.0 months. Another patient showed evidence of disease activity (partial remission) at 47.6 months. Two other patients relapsed at 12.3 months and at 25.7 months, respectively, with greater than 1% HCs. Group 3 (4 patients) had MRD levels greater than 5%. Three patients relapsed at 11.3, 12.1, and 29.6 months, respectively, with greater than 5% HCs. The fourth patient had MRD levels of 5% at 14.6 months and 2% at 20.0 months but was subsequently lost to follow-up. CONCLUSIONS: Quantitative assessment of MRD may be of value in identifying patients at risk for relapse of hairy cell leukemia.