Bortezomib, cyclophosphamide, dexamethasone versus lenalidomide, cyclophosphamide, dexamethasone in multiple myeloma patients at first relapse.

Szczegóły
Abstrakt

Tytuł:: Bortezomib, cyclophosphamide, dexamethasone versus lenalidomide, cyclophosphamide, dexamethasone in multiple myeloma patients at first relapse.
Autorzy:: Montefusco V; Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Corso A; Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Università di Pavia, Pavia, Italy.
Galli M; Hematology, Papa Giovanni XXIII hospital, Bergamo, Italy.
Ardoino I; Istituto di Ricerche Farmacologiche 'Mario Negri' - IRCCS, Milan, Italy.
Pezzatti S; Hematology, San Gerardo hospital, Monza, Italy.
Carniti C; Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Patriarca F; DISM, University of Udine, Udine, Italy.
Gherlinzoni F; Hematology, Ca' Foncello hospital, Treviso, Italy.
Zambello R; Department of Medicine, Hematology and Clinical Immunology Branch, Padua University School of Medicine, Padua, Italy.
Sammassimo S; Hematoncology, European Institute of Oncology, Milan, Italy.
Marcatti M; Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Nozza A; Oncology and Hematology Department, Istituto Clinico Humanitas, Rozzano (MI), Milan, Italy.
Crippa C; Hematology, Spedali Civili di Brescia, Brescia, Italy.
Cafro AM; Department of Oncology/Hematology, Niguarda Ca' Granda Hospital, Milan, Italy.
Baldini L; Hematology/Bone Marrow Transplantation Unit, Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico Ca'Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
Corradini P; Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.; Department of Oncology and Hematology, University of Milan, Milan, Italy.
Źródło:: British journal of haematology [Br J Haematol] 2020 Mar; Vol. 188 (6), pp. 907-917. Date of Electronic Publication: 2020 Jan 02.
Typ publikacji:: Journal Article; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Publication: Oxford : Wiley-Blackwell
Original Publication: Oxford : Blackwell Scientific Publications
MeSH Terms:: Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
Bortezomib/*therapeutic use
Cyclophosphamide/*therapeutic use
Dexamethasone/*therapeutic use
Lenalidomide/*therapeutic use
Multiple Myeloma/*drug therapy
Antineoplastic Combined Chemotherapy Protocols/pharmacology ; Bortezomib/pharmacology ; Cyclophosphamide/pharmacology ; Dexamethasone/pharmacology ; Female ; Humans ; Lenalidomide/pharmacology ; Male ; Middle Aged ; Recurrence ; Treatment Outcome
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Grant Information:: IG-10419 International Associazione Italiana per la Ricerca sul Cancro
Contributed Indexing:: Keywords: bortezomib; lenalidomide; myeloma
Substance Nomenclature:: 69G8BD63PP (Bortezomib)
7S5I7G3JQL (Dexamethasone)
8N3DW7272P (Cyclophosphamide)
F0P408N6V4 (Lenalidomide)
Entry Date(s):: Date Created: 20200104 Date Completed: 20201113 Latest Revision: 20201113
Update Code:: 20240104
DOI:: 10.1111/bjh.16287
PMID:: 31898319
: Czasopismo naukowe

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Bortezomib- and lenalidomide-containing regimens are well-established therapies in multiple myeloma (MM). However, despite their extensive use, head-to-head comparisons have never been performed. Therefore, we compared bortezomib and lenalidomide in fixed-duration therapies. In this open-label, phase III study, we randomized MM patients at first relapse to receive either nine cycles of bortezomib plus cyclophosphamide plus dexamethasone (VCD) or lenalidomide plus cyclophosphamide plus dexamethasone (RCD). The primary endpoint was achievement of a very good partial response (VGPR) or better at six weeks after nine treatment cycles. From March 2011 to February 2015, 155 patients were randomized. VGPR or better was achieved by 12 patients (15%) in the VCD arm and 14 patients (18%) in the RCD arm (P = 0·70). Median progression-free survival (PFS) was 16·3 (95% CI: 12·1-22·4) with VCD and 18·6 months (95% CI: 14·7-25·5) with RCD, and the two-year overall survival (OS) was 75% (95% CI: 66-86%) and 74% (95% CI: 64-85%) respectively. In subgroup analyses, no differences in PFS were observed in bortezomib- and lenalidomide-naïve patients, nor in patients who received a bortezomib-based regimen in first line. Adverse events were consistent with the well-established safety profiles of both drugs. Bortezomib and lenalidomide treatments were equally effective in terms of depth of response, PFS, and OS in MM patients at first relapse.
(© 2019 British Society for Haematology and John Wiley & Sons Ltd.)

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