Pönisch W, Mitrou P S, Merkle K, Herold M, Assmann M, Wilhelm G, Dachselt K, Richter P, Schirmer V, Schulze A, Subert R, Harksel B, Grobe N, Stelzer E, Schulze M, Bittrich A, Freund M, Pasold R, Friedrich Th, Helbig W, Niederwieser D
Department of Hematology and Oncology, University of Leipzig, Johannisallee 32A, 04103, Leipzig, and Hospital Riesa, Germany.
J Cancer Res Clin Oncol. 2006 Apr;132(4):205-12. doi: 10.1007/s00432-005-0074-4. Epub 2006 Jan 10.
This randomized phase III study compared bendamustine and prednisone (BP) to standard melphalan and prednisone (MP) treatment in previously untreated patients with multiple Myeloma (MM).
To be included, patients had to have histologically and cytologically proven stage II with progressive diseases or stage III MM. They were randomly assigned to receive BP (n=68) or MP (n=63). The primary endpoint was the time to treatment failure (TTF). Secondary endpoints included survival, remission rate, toxicity and quality of life.
The overall response rate was 75% in the BP and 70% in the MP group. A significantly higher number of patients treated with BP achieved a complete remission than did patients receiving MP (32 vs. 13%; P=0.007), and the maximum response was achieved more rapidly in patients treated with BP compared to those receiving MP (6.8 vs. 8.7 cycles; P<0.02). TTF and remission duration were significantly longer in the BP group. Patients receiving BP had higher QoL scores and reported pain less frequently than patients receiving MP.
BP is superior to MP with respect to complete remission rate, TTF, cycles needed to achieve maximum remission and quality of life and should be considered the new standard in first-line treatment of MM patients not eligible for transplantation.
本随机III期研究比较了苯达莫司汀与泼尼松(BP)和标准美法仑与泼尼松(MP)治疗既往未经治疗的多发性骨髓瘤(MM)患者的疗效。
纳入患者须经组织学和细胞学证实为II期进展性疾病或III期MM。他们被随机分配接受BP治疗(n = 68)或MP治疗(n = 63)。主要终点是治疗失败时间(TTF)。次要终点包括生存率、缓解率、毒性和生活质量。
BP组的总缓解率为75%,MP组为70%。接受BP治疗的患者完全缓解的人数显著高于接受MP治疗的患者(32%对13%;P = 0.007),与接受MP治疗的患者相比,接受BP治疗的患者达到最大缓解的速度更快(6.8个周期对8.7个周期;P < 0.02)。BP组的TTF和缓解持续时间显著更长。接受BP治疗的患者生活质量评分更高,报告疼痛的频率低于接受MP治疗的患者。
在完全缓解率、TTF、达到最大缓解所需周期数和生活质量方面,BP优于MP,应被视为不适于移植的MM患者一线治疗的新标准。