Department of Lymphoma/Myeloma, University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA.
Am J Clin Oncol. 2012 Dec;35(6):562-5. doi: 10.1097/COC.0b013e31822043f6.
In vitro studies have shown synergistic antimyeloma effects with the combination of bortezomib and alkylating agents. Combinations of bortezomib, cyclophosphamide, and dexamethasone are rational with the prospect of superior antitumor activity with independent toxicity.
Between December 2004 and April 2007, we treated 44 patients with relapsing multiple myeloma with the combination of bortezomib 1.3 mg/m intravenously on days 1, 4, 8, 11; dexamethasone 20 mg/m orally daily for 4 days beginning on days 1, 9 and 17; and cyclophosphamide 70 mg/m orally twice daily for 4 days. A second course was given 1 month later.
Clinical response was observed in 32 patients (73%) including 26 with disease in partial remission (59%), and 6 with disease in complete remission (14%). Side effects were uncommon and mild, except for grade 3 thrombocytopenia in 15%, infection in 5% and constipation in 2% of patients. The median remission time of responding patients was 10 months that contributed to significantly longer median survival for patients with responsive disease (33 mo) than for those with unresponsive disease (12 mo) (P < 0.01).
Bortezomib-cyclophosphamide-dexamethasone was an effective, well-tolerated combination for the treatment of relapsing multiple myeloma.
体外研究表明硼替佐米与烷化剂联合使用具有协同抗骨髓瘤作用。硼替佐米、环磷酰胺和地塞米松的联合具有独立毒性的优势抗肿瘤活性的前景。
2004 年 12 月至 2007 年 4 月，我们用硼替佐米 1.3mg/m 静脉注射，第 1、4、8、11 天；地塞米松 20mg/m 口服，第 1、9、17 天，共 4 天；环磷酰胺 70mg/m 口服，每日 2 次，第 1、9、17 天共 4 天。一个月后进行第二个疗程。
32 例患者（73%）观察到临床反应，包括 26 例部分缓解（59%），6 例完全缓解（14%）。除 15%的患者出现 3 级血小板减少症、5%的患者发生感染和 2%的患者发生便秘外，副作用不常见且轻微。有反应的患者的中位缓解时间为 10 个月，这使得对有反应的疾病患者（33 个月）的中位生存时间明显长于无反应的疾病患者（12 个月）（P <0.01）。
硼替佐米-环磷酰胺-地塞米松是一种有效且耐受性良好的治疗复发性多发性骨髓瘤的联合用药。
