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Systemic Anti-Cancer Therapy Regimen Library

Home > PCN MM - MPT [melphalan, prEDNISone and thalidomide]

PCN MM - MPT [melphalan, prEDNISone and thalidomide]

Treatment Overview

Cycles 1 to 12 - 42 days

Cycle length:
42

Cycle details

Cycles 1 to 12 - 42 days

Medication Dose Route Days Max Duration
prEDNISone 100 mg flat dosing Once daily oral administration 1 to 4
melphalan 9 mg/m² Once daily oral administration 1 to 4
thalidomide * 100 mg Once daily oral administration 1 to 42

Full details

Cycles 1 to 12 - 42 days

Day: 1

Medication Dose Route Max duration Details
prEDNISone 100 mg flat dosing Once daily oral administration
Instructions:
Take in the morning with food.
melphalan 9 mg/m² Once daily oral administration
Instructions:

Swallow whole with a large glass of water. Take at the same time of day and same timing in relation to food. Absorption of melphalan is highly variable and can be reduced by food.

KEEP IN FRIDGE - DO NOT FREEZE.

Round dose to closest multiple of 2 mg tablets.
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 2

Medication Dose Route Max duration Details
prEDNISone 100 mg flat dosing Once daily oral administration
Instructions:
Take in the morning with food.
melphalan 9 mg/m² Once daily oral administration
Instructions:

Swallow whole with a large glass of water. Take at the same time of day and same timing in relation to food. Absorption of melphalan is highly variable and can be reduced by food.

KEEP IN FRIDGE - DO NOT FREEZE.

Round dose to closest multiple of 2 mg tablets.
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 3

Medication Dose Route Max duration Details
prEDNISone 100 mg flat dosing Once daily oral administration
Instructions:
Take in the morning with food.
melphalan 9 mg/m² Once daily oral administration
Instructions:

Swallow whole with a large glass of water. Take at the same time of day and same timing in relation to food. Absorption of melphalan is highly variable and can be reduced by food.

KEEP IN FRIDGE - DO NOT FREEZE.

Round dose to closest multiple of 2 mg tablets.
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 4

Medication Dose Route Max duration Details
prEDNISone 100 mg flat dosing Once daily oral administration
Instructions:
Take in the morning with food.
melphalan 9 mg/m² Once daily oral administration
Instructions:

Swallow whole with a large glass of water. Take at the same time of day and same timing in relation to food. Absorption of melphalan is highly variable and can be reduced by food.

KEEP IN FRIDGE - DO NOT FREEZE.

Round dose to closest multiple of 2 mg tablets.
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 5

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 6

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 7

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 8

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 9

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 10

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 11

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 12

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 13

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 14

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 15

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 16

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 17

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 18

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 19

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 20

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 21

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 22

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 23

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 24

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 25

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 26

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 27

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 28

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 29

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 30

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 31

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 32

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 33

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 34

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 35

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 36

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 37

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 38

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 39

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 40

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 41

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Day: 42

Medication Dose Route Max duration Details
thalidomide * 100 mg Once daily oral administration
Instructions:
Take at night at least an hour after food. This medicine may make you sleepy and make it dangerous to drive or operate machinery. Limit alcohol intake.
Additional details:

Additional details

Section 1: Teratogenic effects

All patients must fulfil the requirements of the pregnancy prevention risk management programme to ensure pregnant women are not exposed to thalidomide. 

Supportive Care Factors

Factor Value
Antiviral prophylaxis for herpes virus: Routine antiviral prophylaxis may be considered
Emetogenicity: Minimal to low
Gastroprotection: Gastroprotection may be considered
Pneumocystis jirovecii pneumonia (PJP) prophylaxis: Routine antibiotic prophylaxis may be considered
Thromboprophylaxis: Thromboprophylaxis is recommended
Tumour lysis syndrome prophylaxis: Tumour lysis syndrome prophylaxis may be considered

Antiviral prophylaxis for hepatitis B virus: Guidance is limited to high-risk anti-cancer medicines. Clinicians will need to assess individual patient risk for other anti-cancer medicines.

References

Palumbo, A., A. Bertola, P. Musto, et al. 2005. "Oral melphalan, prEDNIsone, and thalidomide for newly diagnosed patients with myeloma." Cancer. 104(7):1428-1433. , PMID: 16116606

Palumbo, A., S. Bringhen, T. Caravita, et al. 2006. "Oral melphalan and prEDNIsone chemotherapy plus thalidomide compared with melphalan and prEDNIsone ....." Lancet. 367(9513):825-831. , PMID: 16530576

Palumbo, A., S. Bringhen, A. M. Liberati, et al. 2008. "Oral melphalan, prEDNIsone, and thalidomide in elderly patients with multiple myeloma: updated results of a randomized controlled trial." Blood 112(8):3107-3114. , PMID: 18505783

Facon, T., J. Y. Mary, C. Hulin, et al. 2007. "Melphalan and prEDNIsone plus thalidomide versus melphalan and prEDNIsone alone or reduced-intensity autologous stem cell transplantation....." Lancet. 370(9594):1209-1218. , PMID: 17920916

Hulin, C., T. Facon, P. Rodon, et al. 2009. "Efficacy of melphalan and prEDNIsone plus thalidomide in patients older than 75 years with newly diagnosed multiple myeloma: IFM 01/01 trial." J Clin Oncol 27(22):3664-3670., PMID: 19451428

Healthcare Logistics Alkeran New Zealand Medicine Datasheet 28 September 2021 https://www.medsafe.govt.nz/profs/datasheet/a/alkerantab.pdf.

Regimen details sometimes vary slightly from the published literature after recommendation by expert committee consensus.

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.