Auel Britta, Goldschmidt Hartmut, Geer Thomas, Moehler Thomas M, Platzbecker Uwe, Naumann Ralph, Blau Igor, Hänel Mathias, Knauf Wolfgang, Nückel Holger, Salwender Hans-Jürgen, Scheid Christof, Weisel Katja, Gorschlüter Marcus, Glasmacher Axel, Schmidt-Wolf Ingo G H
Department of Internal Medicine III, Center for Integrated Oncology (CIO), University Hospital Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany.
Indian J Hematol Blood Transfus. 2012 Jun;28(2):67-76. doi: 10.1007/s12288-011-0103-1. Epub 2011 Aug 18.
Treatment of relapsed or refractory multiple myeloma remains a challenge and novel treatment regimen are required. Here, a matched pair analysis was performed comparing TCID (thalidomide, cyclophosphamide, idarubicin, dexamethasone) treatment to the treatment of patients with VID (vincristine, idarubicin, dexamethasone) or with VRID (vinorelbine, idarubicin, dexamethasone) for relapsed or refractory multiple myeloma. In total, 197 patients were enrolled in multicenter trials. After matching for important prognostic variables 46 matched-pairs (total of 138 patients) could be analysed with regard to survival, toxicity and efficacy. Interestingly, a significant improvement of overall response rate (ORR) for TCID treatment compared to VID and VRID was found. In addition, TCID treatment also led to a significantly higher overall survival (OS) as well as progression-free survival (PFS) compared to VID and VRID. In conclusion, TCID treatment appears to be superior to VRID and VID treatment in patients with progressive or refractory myeloma.
复发或难治性多发性骨髓瘤的治疗仍然是一项挑战,需要新的治疗方案。在此,进行了一项配对分析,比较沙利度胺、环磷酰胺、伊达比星、地塞米松(TCID)方案与长春新碱、伊达比星、地塞米松(VID)方案或长春瑞滨、伊达比星、地塞米松(VRID)方案治疗复发或难治性多发性骨髓瘤患者的疗效。共有197例患者参加了多中心试验。在对重要的预后变量进行匹配后,可对46对配对患者(共138例)的生存、毒性和疗效进行分析。有趣的是,与VID和VRID相比,发现TCID治疗的总缓解率(ORR)有显著提高。此外,与VID和VRID相比,TCID治疗还导致总生存期(OS)以及无进展生存期(PFS)显著延长。总之,对于进展性或难治性骨髓瘤患者,TCID治疗似乎优于VRID和VID治疗。