{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T04:15:36Z","timestamp":1791778536904,"version":"4.3.4"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2006,1,10]],"date-time":"2006-01-10T00:00:00Z","timestamp":1136851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2006,2,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Pegylated liposomal doxorubicin has pharmacologic and safety advantages over conventional doxorubicin.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>For this noninferiority trial, 192 patients with newly diagnosed, active multiple myeloma were randomized to receive either combined pegylated liposomal doxorubicin (40 mg\/m<jats:sup>2<\/jats:sup>) and vincristine (1.4 mg\/m<jats:sup>2<\/jats:sup>; maximum, 2.0 mg) as an intravenous infusion on Day 1 plus reduced\u2010dose dexamethasone (40 mg) orally on Days 1\u20134 (DVd) (<jats:italic>n<\/jats:italic> = 97 patients) or combined vincristine (0.4 mg per day) and conventional doxorubicin (9 mg\/m<jats:sup>2<\/jats:sup> per day) as a continuous intravenous infusion on Days 1\u20134 plus reduced\u2010dose dexamethasone (VAd) (<jats:italic>n<\/jats:italic> = 95 patients) for at least 4 cycles. Treatment was repeated every 4 weeks until patients either achieved maximal response, disease progression, or unacceptable toxicity or underwent transplantation. The primary endpoints were response and toxicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Objective response rates (DVd, 44%; VAd, 41%), progression\u2010free survival (hazard ratio, 1.11; <jats:italic>P<\/jats:italic> = 0.69), and overall survival (hazard ratio, 0.88; <jats:italic>P<\/jats:italic> = 0.67) were similar between the treatment groups. However, DVd was associated with significantly less Grade 3\/4 neutropenia or neutropenic fever (10% vs. 24%; <jats:italic>P<\/jats:italic> = 0.01), a lower incidence of sepsis, and less antibiotic use. Compared with VAd, DVd also significantly decreased the need for central venous access (<jats:italic>P<\/jats:italic> &lt; 0.0001) and growth\u2010factor support (<jats:italic>P<\/jats:italic> = 0.03) and resulted in less alopecia (20% vs. 44%; <jats:italic>P<\/jats:italic> &lt; 0.001) but more hand\u2013foot syndrome (25% vs. 1%; <jats:italic>P<\/jats:italic> &lt; 0.001), mainly Grade 1\/2.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The DVd regimen demonstrated similar efficacy with less toxicity and supportive care compared with VAd, which should improve clinical utility and optimize the opportunity for transplantation. 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