I read a post on one of the myeloma forums yesterday that (paraphrase) "dexamethasone makes all conventional therapies work better..." I can't site studies but I think this statement is true.
The important thing to keep in mind is that the dose of dexamethasone, how much you take each day or each week is critical. Below is a link to a study on the greater effectiveness of thal/dex high dose vs low dose as well as forum comments about low dose dex.
Further, I came acros this study today from last December talking about how steroid dose was a factor in both efficacy and tolerance.
"Fewer Steroids Suggested For Myeloma, United Press International
December 11, 2007
ROCHESTER, Minn. -- A U.S. study suggests multiple myeloma therapy involving
high doses of steroids might be decreasing survival rates and increasing
side effects.
The results of the Eastern Cooperative Oncology Group's Phase III clinical
trial for multiple myeloma showed significantly better overall survival
using low-dose dexamethasone (steroid) therapy as compared with high-dose
dexamethasone.
"The standard treatment for myeloma usually includes high doses of steroids
such as dexamethasone. In this study we were hoping to find a lower dose of
steroids would be just as effective," said Dr. S. Vincent Rajkumar of the
Mayo Clinic Cancer Center, the study's lead investigator. "We were surprised
to find that the regimen with high-dose steroids actually was decreasing
survival, besides contributing to increased side effects.
"The lower survival rates with the high-dose dexamethasone can be attributed
to disease progression as well as treatment-related toxicities," he added.
"This is a major advance in the treatment of this cancer, and also gives
researchers a new direction to explore -- that more is not necessarily
better."
The research was presented Monday in Atlanta during the annual meeting of
the American Society of Hematology."
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