Bortezomib before and after high-dose therapy in myeloma

Autor: Marian Stevens-Kroef, M. van Marwijk Kooy, Henk M. Lokhorst, Hans-Walter Lindemann, Anna Potamianou, Gerard M. J. Bos, B. van der Holt, Igor Wolfgang Blau, Annemiek Broijl, Christoph Scheid, Peter Brossart, Pieter Sonneveld, Sonja Zweegman, R. Schaafsma, Sandra Croockewit, Reinier Raymakers, Le Jarari, Ulrich Duehrsen, H Salwender, Jens Hillengass, Dirk Hose, Elias K. Mai, Anna Jauch, Marc-Steffen Raab, Michael Pfreundschuh, Thomas Hielscher, Paula F. Ypma, Marie-Jose Kersten, Katja Weisel, Edo Vellenga, H. Goldschmidt, Uta Bertsch
Přispěvatelé: Guided Treatment in Optimal Selected Cancer Patients (GUTS), Stem Cell Aging Leukemia and Lymphoma (SALL), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Interne Geneeskunde, MUMC+: MA Hematologie (9), Hematology, CCA - Cancer immunology, CCA - Imaging, CCA - Biomarkers, CCA - Clinical Therapy Development, CCA - Evaluation of Cancer Care, CCA - Target Discovery & Preclinial Therapy Development, Anatomy and neurosciences, CCA - Cancer Treatment and Quality of Life, Clinical Haematology, AII - Amsterdam institute for Infection and Immunity, AII - Inflammatory diseases
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
Melphalan
2ND PRIMARY MALIGNANCIES
Cancer Research
DIAGNOSED MULTIPLE-MYELOMA
Medizin
PLUS DEXAMETHASONE
Bortezomib
0302 clinical medicine
Autologous stem-cell transplantation
Tumours of the digestive tract Radboud Institute for Molecular Life Sciences [Radboudumc 14]
Multiple myeloma
INTERGROUPE FRANCOPHONE
Hazard ratio
Hematopoietic Stem Cell Transplantation
Hematology
Middle Aged
Prognosis
Progression-Free Survival
Thalidomide
Oncology
030220 oncology & carcinogenesis
DEXAMETHASONE COMBINATION
DELETION 17P
Female
Multiple Myeloma
medicine.drug
Rare cancers Radboud Institute for Health Sciences [Radboudumc 9]
Adult
medicine.medical_specialty
Adolescent
Urology
MAINTENANCE TREATMENT
Transplantation
Autologous
Young Adult
03 medical and health sciences
All institutes and research themes of the Radboud University Medical Center
medicine
Humans
Progression-free survival
Aged
Chromosome Aberrations
business.industry
STEM-CELL TRANSPLANTATION
STAGING SYSTEM
medicine.disease
RANDOMIZED-TRIAL
Surgery
Transplantation
business
Follow-Up Studies
030215 immunology
Zdroj: Leukemia, 32(2), 383-390. Nature Publishing Group
Leukemia, 32, 2, pp. 383-390
Goldschmidt, H, Lokhorst, H M, Mai, E K, van der Holt, B, Blau, I W, Zweegman, S, Weisel, K C, Vellenga, E, Pfreundschuh, M, Kersten, M J, Scheid, C, Croockewit, S, Raymakers, R, Hose, D, Potamianou, A, Jauch, A, Hillengass, J, Stevens-Kroef, M, Raab, M S, Broijl, A, Lindemann, H W, Bos, G M J, Brossart, P, van Marwijk Kooy, M, Ypma, P, Duehrsen, U, Schaafsma, R M, Bertsch, U, Hielscher, T, Jarari, L, Salwender, H J & Sonneveld, P 2018, ' Bortezomib before and after high-dose therapy in myeloma : long-term results from the phase III HOVON-65/GMMG-HD4 trial ', Leukemia, vol. 32, no. 2, pp. 383-390 . https://doi.org/10.1038/leu.2017.211
Leukemia, 32(2), 383. Nature Publishing Group
Leukemia, 32, 383-390
ISSN: 0887-6924
Popis: The Dutch-Belgian Cooperative Trial Group for Hematology Oncology Group-65/German-speaking Myeloma Multicenter Group-HD4 (HOVON-65/GMMG-HD4) phase III trial compared bortezomib (BTZ) before and after high-dose melphalan and autologous stem cell transplantation (HDM, PAD arm) compared with classical cytotoxic agents prior and thalidomide after HDM (VAD arm) in multiple myeloma (MM) patients aged 18-65 years. Here, the long-term follow-up and data on second primary malignancies (SPM) are presented. After a median follow-up of 96 months, progression-free survival (censored at allogeneic transplantation, PFS) remained significantly prolonged in the PAD versus VAD arm (hazard ratio (HR) = 0.76, 95% confidence interval (95% CI) of 0.65-0.89, P = 0.001). Overall survival (OS) was similar in the PAD versus VAD arm (HR = 0.89, 95% CI: 0.74-1.08, P = 0.24). The incidence of SPM were similar between the two arms (7% each, P = 0.73). The negative prognostic effects of the cytogenetic aberration deletion 17p13 (clone size >= 10%) and renal impairment at baseline (serum creatinine > 2 mg dl(-1)) on PFS and OS remained abrogated in the PAD but not VAD arm. OS from first relapse/progression was similar between the study arms (HR = 1.02, P = 0.85). In conclusion, the survival benefit with BTZ induction/maintenance compared with classical cytotoxic agents and thalidomide maintenance is maintained without an increased risk of SPM.
Databáze: OpenAIRE
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