Bortezomib, melphalan, prednisone, and thalidomide for relapsed multiple myeloma
| Autor: | Mario Boccadoro, Fortunato Morabito, Tommaso Caravita, Giulia Benevolo, Ilaria Avonto, Norbert Pescosta, Patrizia Falco, Federica Cavallo, Vincenzo Callea, Pellegrino Musto, Clotilde Cangialosi, Antonio Palumbo, Patrizia Pregno, Maria Teresa Ambrosini, Sara Bringhen |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
Male Melphalan medicine.medical_specialty medicine.drug_class Immunology Salvage therapy Biochemistry Gastroenterology Bortezomib chemistry.chemical_compound Recurrence Prednisone Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Multiple myeloma Aged Salvage Therapy business.industry Drug Tolerance Cell Biology Hematology Middle Aged medicine.disease Boronic Acids Nitrogen mustard Thalidomide Surgery chemistry Pyrazines Corticosteroid Female Safety Multiple Myeloma business medicine.drug |
| Zdroj: | Blood. 109:2767-2772 |
| ISSN: | 1528-0020 0006-4971 |
| Popis: | In multiple myeloma (MM), the addition of thalidomide or bortezomib to the standard oral melphalan/prednisone combination significantly increased response rate and event-free survival. In this multicenter phase 1/2 trial, dosing, safety, and efficacy of the 4-drug combination, bortezomib, melphalan, prednisone, and thalidomide (VMPT) was determined. Bortezomib was administered at 3 dose levels (1.0 mg/m2, 1.3 mg/m2, or 1.6 mg/m2) on days 1, 4, 15, and 22; melphalan was given at a dose of 6 mg/m2 on days 1 through 5 and prednisone at 60 mg/m2 on days 1 through 5. Thalidomide was delivered at 50 mg on days 1 through 35. Each course was repeated every 35 days. The maximum tolerated dose of bortezomib was 1.3 mg/m2. Thirty patients with relapsed or refractory MM were enrolled; 20 patients (67%) achieved a partial response (PR) including 13 patients (43%) who achieved at least a very good PR. Among 14 patients who received VMPT as second-line treatment, the PR rate was 79% and the immunofixation-negative complete response rate 36%. The 1-year progression-free survival was 61%, and the 1-year survival from study entry was 84%. Grade 3 nonhematologic adverse events included infections (5 patients), fatigue (1), vasculitis (1), and peripheral neuropathy (2); no grade 4 toxicities were recorded. Initial results showed that VMPT is an effective salvage therapy with a very high proportion of responses. The incidence of neurotoxicities was unexpectedly low. |
| Databáze: | OpenAIRE |
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