BACKGROUND: This was an open-label, observational, prospective assessment. We conducted an analysis of the impact of bortezomib-based therapy (PAD: bortezomib, doxorubicin, high-dose dexamethasone vs. CBd: cyclophosphamide bortezomib, low-dose dexamethasone) on the survival rates and adverse events in elderly patients with newly diagnosed multiple myeloma (MM). METHODS: Out of 303 patients, 128 received the PAD regimen and the other 175 patients received the CBd induction therapy (age 65-89 years). Baseline patient characteristics between the two cohorts were balanced in age (P = 0.69), international staging system (ISS) prognostic stages (P = 0.90), serum calcium (P = 0.70), and serum creatinine (P = 0.52). RESULTS: Overall response (OS) after the induction chemotherapy was achieved in 214 of 303 patients (70.6 %), with no significant differences observed between the two treatment groups (71.9 vs. 69.7 %, P = 0.68). Patients with ISS stage 2 reached the same 5-year OS advantages compared to patients with ISS stage 1, because they received bortezomib-based PAD or CBd treatments. Patients receiving CBd protocol gained similar satisfactory progression-free survival (PFS) results when compared to the PAD regimen group: PFS at 5 years reached 58.2 versus 58.9 % (P = 0.85). Five-year OS in the CBd arm had significant advantages compared to the PAD group, 79.9 versus 49.9 % (P < 0.05). The overall safety profiles showed that 26 of 128 (20.3 %) patients died in the PAD arm, while 13 of 175 patients died (7.4 %) in the CBd group (P < 0.01). Similarly, the PAD arm had a higher serious infection rate than that of the CBd arm (39.2 vs. 13.1 %, P < 0.01). CONCLUSIONS: Bortezomib benefits elderly patients with newly diagnosed MM; they achieve satisfactory treatment responses and survival advantages. Further, patients treated with CBd have superior treatment advantages, with a predictable safety profile, when compared to the PAD regimen.
BACKGROUND: This was an open-label, observational, prospective assessment. We conducted an analysis of the impact of bortezomib-based therapy (PAD: bortezomib, doxorubicin, high-dose dexamethasone vs. CBd: cyclophosphamide bortezomib, low-dose dexamethasone) on the survival rates and adverse events in elderly patients with newly diagnosed multiple myeloma (MM). METHODS: Out of 303 patients, 128 received the PAD regimen and the other 175 patients received the CBd induction therapy (age 65-89 years). Baseline patient characteristics between the two cohorts were balanced in age (P = 0.69), international staging system (ISS) prognostic stages (P = 0.90), serum calcium (P = 0.70), and serum creatinine (P = 0.52). RESULTS: Overall response (OS) after the induction chemotherapy was achieved in 214 of 303 patients (70.6 %), with no significant differences observed between the two treatment groups (71.9 vs. 69.7 %, P = 0.68). Patients with ISS stage 2 reached the same 5-year OS advantages compared to patients with ISS stage 1, because they received bortezomib-based PAD or CBd treatments. Patients receiving CBd protocol gained similar satisfactory progression-free survival (PFS) results when compared to the PAD regimen group: PFS at 5 years reached 58.2 versus 58.9 % (P = 0.85). Five-year OS in the CBd arm had significant advantages compared to the PAD group, 79.9 versus 49.9 % (P < 0.05). The overall safety profiles showed that 26 of 128 (20.3 %) patients died in the PAD arm, while 13 of 175 patients died (7.4 %) in the CBd group (P < 0.01). Similarly, the PAD arm had a higher serious infection rate than that of the CBd arm (39.2 vs. 13.1 %, P < 0.01). CONCLUSIONS:Bortezomib benefits elderly patients with newly diagnosed MM; they achieve satisfactory treatment responses and survival advantages. Further, patients treated with CBd have superior treatment advantages, with a predictable safety profile, when compared to the PAD regimen.
Authors: Daryl Tan; Gerrard Teoh; L C Lau; Alvin Lim; T H Lim; K C Yap; P Premalatha; Z T Lao; Nelson Wee; Christine Choo; H C Wee; S Su; Y S Lee; L H Lee; William Hwang; Y T Goh Journal: Am J Hematol Date: 2010-10 Impact factor: 10.047
Authors: Pieter Sonneveld; Ingo G H Schmidt-Wolf; Bronno van der Holt; Laila El Jarari; Uta Bertsch; Hans Salwender; Sonja Zweegman; Edo Vellenga; Annemiek Broyl; Igor W Blau; Katja C Weisel; Shulamiet Wittebol; Gerard M J Bos; Marian Stevens-Kroef; Christof Scheid; Michael Pfreundschuh; Dirk Hose; Anna Jauch; Helgi van der Velde; Reinier Raymakers; Martijn R Schaafsma; Marie-Jose Kersten; Marinus van Marwijk-Kooy; Ulrich Duehrsen; Walter Lindemann; Pierre W Wijermans; Henk M Lokhorst; Hartmut M Goldschmidt Journal: J Clin Oncol Date: 2012-07-16 Impact factor: 44.544
Authors: Philip R Greipp; Jesus San Miguel; Brian G M Durie; John J Crowley; Bart Barlogie; Joan Bladé; Mario Boccadoro; J Anthony Child; Herve Avet-Loiseau; Jean-Luc Harousseau; Robert A Kyle; Juan J Lahuerta; Heinz Ludwig; Gareth Morgan; Raymond Powles; Kazuyuki Shimizu; Chaim Shustik; Pieter Sonneveld; Patrizia Tosi; Ingemar Turesson; Jan Westin Journal: J Clin Oncol Date: 2005-04-04 Impact factor: 44.544
Authors: A K Stewart; P L Bergsagel; P R Greipp; A Dispenzieri; M A Gertz; S R Hayman; S Kumar; M Q Lacy; J A Lust; S J Russell; T E Witzig; S R Zeldenrust; D Dingli; C B Reeder; V Roy; R A Kyle; S V Rajkumar; R Fonseca Journal: Leukemia Date: 2007-01-18 Impact factor: 11.528
Authors: Heinz Ludwig; Luisa Viterbo; Richard Greil; Tamas Masszi; Ivan Spicka; Ofer Shpilberg; Roman Hajek; Anna Dmoszynska; Bruno Paiva; María-Belén Vidriales; Graca Esteves; Anne Marie Stoppa; Don Robinson; Deborah Ricci; Andrew Cakana; Christopher Enny; Huaibao Feng; Helgi van de Velde; Jean-Luc Harousseau Journal: J Clin Oncol Date: 2012-10-22 Impact factor: 44.544