Table 4:

Recommended dose modifications in patients with peripheral neuropathy

Bortezomiba	Grade of PN		G1	G1 (painful) or G2	G2 (painful) or G3
	IMWGc	Twice-weekly	↓ to 1 mg/m2 or shift to once-weekly		D/C
		Once-weekly	↓ to 1mg/m2	D/C temporarily or ↓ dose to 1mg/m2
	EMNc		NA	↓ to 0.7-1.0 mg/m2d	D/C till down-escalated to G1 Resume at 50% dose
Thalidomideb	Grade of PN		G1	G2	G3-4
	IMWG		50% dose reduction	D/C; Resume at 50% dose post resolution	D/C
	EMN		NA	50% dose reduction	D/C till down-escalated to G1 Resume at 50%

Abbreviations: D/C= discontinue; EMN=European Myeloma Network; G=grade; IMWG=International Myeloma Working Group; NA=not available; PN=peripheral neuropathy; ↓=decrease.

^aDose of bortezomib is 1.3 mg/m².

^bDose of thalidomide is 100 mg.

^cDiscontinue if G4 develops.

^dPreferably subcutaneous.