Congress Abstracts 2006

155

BORTEZOMIB (V) IN COMBINATION WITH DOXIL (D) AND THALIDOMIDE (T) YIELD HIGH RESPONSE RATE IN PATIENTS WITH REFRACTORY MULTIPLE MYELOMA. Kena Miller, FNP, and Laurie Musiali, RN, BSN, Roswell Park Cancer Institute, Buffalo, NY.

Multiple Myeloma (MM) is an incurable hematologic cancer. all patients (pts) eventually relapse and die of progressive disease. Development of newer therapies and combination regimens are imperative for management of patients with relapsed/refractory disease. While V is approved for MM the response rates are low (27%) with only 11% achieving a complete response(CR). In a phase II clinical trial we investigated the combination of V with D and T (VDT) and noted high over response rates (ORR).

In this abstract we report on the results of this novel combination that was developed in collaboration with the principal investigator and the clinical oncology nurse practitioner (C-ONP). Side effect experience of the C-ONP with B using 1,4, 8,11 schedule resulted in development of this unique dosing schedule (V on days 1,4, 15 and 18) that resulted in not only improved tolerability but also higher response rates when combined with D and T.

This unique collaboration resulted in development of new treatment regimen that is not only patient friendly but also yielded high response rates in heavily pretreated patients.

VDT regimen is given as:
V= 1.3mg/m2 days 1,4,15,18
D=20mg/m2 days 1,15
T=100-200mg daily
each cycle is q28,days.

This schedule improved tolerability and resulted in higher ORR (62.55) and CR (25%)rates in 21 MM patients with relapsed and refractory disease.

Knowledge of the side effect profile of these drugs reported by the C-ONP directly helped develop this unique combination treatment with patient friendly schedule and without compromise of efficacy.

VDT has high ORR and CR rates and is an effect salvage regimen now used at our cancer center. The role of C-ONP in development of this regimen is unique and highlights the benefit of close collaboration of the treating physician with the clinical nurse practitioner and the clinical research nurses.