Lenalidomide and low‐dose dexamethasone (Rd) versus bortezomib, melphalan, prednisone (VMP) in elderly newly diagnosed multiple myeloma patients: A comparison of two prospective trials
| Autor: | Massimo Gentile, Valeria Magarotto, Massimo Offidani, Pellegrino Musto, Sara Bringhen, Maria Teresa Petrucci, Francesca Gay, Alessandra Larocca, Giuseppina Uccello, Annamaria Petrungaro, Ernesto Vigna, Rosa Greco, Anna Grazia Recchia, Giovanni Tripepi, Roberto Ria, Francesco Di Raimondo, Antonio Palumbo, Fortunato Morabito |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Oncology medicine.medical_specialty Dexamethasone Disease-Free Survival law.invention Bortezomib 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Prospective Studies 030212 general & internal medicine Progression-free survival Lenalidomide Melphalan Survival rate Multiple myeloma Aged business.industry Hematology medicine.disease Thalidomide Tumor Burden Surgery Survival Rate Regimen Treatment Outcome 030220 oncology & carcinogenesis Prednisone Female Multiple Myeloma business medicine.drug |
| Zdroj: | American Journal of Hematology. 92:244-250 |
| ISSN: | 1096-8652 0361-8609 |
| DOI: | 10.1002/ajh.24621 |
| Popis: | There are currently no direct head-to-head clinical trials evaluating bortezomib-melphalan-prednisone (VMP) versus lenalidomide and low-dose dexamethasone (Rd). VMP (257 cases) and Rd (222 cases) arms of two randomized phase III trials were employed to assess the treatment influence on outcome in untreated elderly MM patients. Progression free survival (PFS) and overall survival (OS) were the primary and secondary end-points, respectively, and were investigated according to treatments administered over a 60-months follow-up period. While VMP significantly reduced the disease progression rate between enrolment and 12 months of follow-up, no difference between the two schedules was found between 12 and 32 months. After 32 months, Rd-treated patients had a lower incidence of disease progression. A statistically significant higher OS rate was seen in the VMP arm, which was maintained after data adjustment for potential confounders. Both approaches showed acceptable toxicity profiles. The profound tumor reduction by VMP over Rd justifies the initial higher PFS rate in favor of the bortezomib schedule, while the Rd regimen overcomes this evident initial drawback in reducing the tumor burden by long-term drug administration, gaining a subsequent improved disease control. VMP is associated with a significant reduced risk of death. This study may help physicians make a more informed therapy choice. |
| Databáze: | OpenAIRE |
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