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Hematologic Malignancies • Medical Oncology • Myeloma • NCI-CCC Tumor Board Question • UCSF • NCI-CCC Myeloma Tumor Board Question
How do you approach patients with recurrent grade 3+ neutropenia on IMiD-containing regimens (e.g., VRd or KRd) beyond dose reductions?
For example: shorten IMiD duration each cycle, add scheduled G-CSF, add antibacterial prophylaxis, etc.
Answer from: Medical Oncologist at Community Practice
IMiD dosing is a challenge. Let's start with what we know:
The FDA approved dose of thalidomide is out of date and the OPTIMUM trial suggests 100 mg PO qHS is the "best" dose (Kropff et al., PMID 22133776) because 400 mg is far too toxic.
The phase 1 of Pomalidomide does not demonstrate superiorit...
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