BACKGROUND: Multiple myeloma is an incurable disease and after several lines of chemotherapy, patients enter a phase in which no standard treatment options are available. The poor outlook of these patients requires mild, palliative therapy with low toxicity. Previously used regimens either require frequent hospital attendance, lack efficacy or have significant toxicity. METHODS: In the current study, daily low dose, oral cyclophosphamide (100 mg) and prednisone (10-20 mg; CP) were administered to patients with advanced myeloma. Forty-two patients with progressive disease after melphalan-based and VAD treatment were enrolled. RESULTS: Objective responses were observed in 29 of 42 (69%) patients. In responding patients, median overall survival and progression-free survival were 22.2 months and 15.0 months, respectively. In non-responders, median OS was 3.5 months only. Side-effects were limited. Cytopenia was the most frequent event (8/29) prompting dose reduction. CP had to be stopped permanently in four patients (two cytopenia, two infections). CONCLUSION: Orally administered, low dose continuous CP is a feasible, effective and well-tolerated regimen in the management of advanced multiple myeloma.
BACKGROUND:Multiple myeloma is an incurable disease and after several lines of chemotherapy, patients enter a phase in which no standard treatment options are available. The poor outlook of these patients requires mild, palliative therapy with low toxicity. Previously used regimens either require frequent hospital attendance, lack efficacy or have significant toxicity. METHODS: In the current study, daily low dose, oral cyclophosphamide (100 mg) and prednisone (10-20 mg; CP) were administered to patients with advanced myeloma. Forty-two patients with progressive disease after melphalan-based and VAD treatment were enrolled. RESULTS: Objective responses were observed in 29 of 42 (69%) patients. In responding patients, median overall survival and progression-free survival were 22.2 months and 15.0 months, respectively. In non-responders, median OS was 3.5 months only. Side-effects were limited. Cytopenia was the most frequent event (8/29) prompting dose reduction. CP had to be stopped permanently in four patients (two cytopenia, two infections). CONCLUSION: Orally administered, low dose continuous CP is a feasible, effective and well-tolerated regimen in the management of advanced multiple myeloma.
Authors: R Hájek; T Masszi; M T Petrucci; A Palumbo; L Rosiñol; A Nagler; K L Yong; A Oriol; J Minarik; L Pour; M A Dimopoulos; V Maisnar; D Rossi; H Kasparu; J Van Droogenbroeck; D B Yehuda; I Hardan; M Jenner; M Calbecka; M Dávid; J de la Rubia; J Drach; Z Gasztonyi; S Górnik; X Leleu; M Munder; M Offidani; N Zojer; K Rajangam; Y-L Chang; J F San-Miguel; H Ludwig Journal: Leukemia Date: 2016-06-24 Impact factor: 11.528
Authors: Laurens E Franssen; Inger S Nijhof; Chad C Bjorklund; Hsiling Chiu; Ruud Doorn; Jeroen van Velzen; Maarten Emmelot; Berris van Kessel; Mark-David Levin; Gerard M J Bos; Annemiek Broijl; Saskia K Klein; Harry R Koene; Andries C Bloem; Aart Beeker; Laura M Faber; Ellen van der Spek; Reinier Raymakers; Pieter Sonneveld; Sonja Zweegman; Henk M Lokhorst; Anjan Thakurta; Xiaozhong Qian; Tuna Mutis; Niels W C J van de Donk Journal: Oncotarget Date: 2018-09-21