Pegylated Liposomal Doxorubicin in Salvage Chemotherapy for Multiple Myeloma Patients

Anthracyclines show anti myeloma effects, being part of active regimens like infusional vincristine/ doxorubicin/ pulsed dexamethasone (VAD) in the past and recently of bortezomib/doxorubicin/pulsed dexamethasone (PAD) for the treatment of multiple myeloma. The recent introduction of pegylated liposomal doxorubicin has led to the development of newer anthracycline-containing regimens with improved toxicity profiles. In vitro, anthracyclines are able of suppressing bortezomib-mediated induction of some stress response proteins with a large synergic effect. Clinical trials have shown impressive activity of pegylated liposomal doxorubicin and conventional doxorubicin in combination with bortezomib in patients with relapsed/refractory myeloma. Herein, we review the clinical data supporting the use of pegylated liposomal doxorubicin combined to active agents in salvage regimens for relapsed/ refractory multiple myeloma patients.