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 |
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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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