Rajan Archana M, Rajkumar S Vincent
Medical College of Wisconsin Affiliated Hospitals, Milwaukee, WI.
Mayo Clinic, Rochester, MN.
Semin Oncol. 2016 Dec;43(6):700-702. doi: 10.1053/j.seminoncol.2016.11.003. Epub 2016 Nov 5.
We review the options for the treatment of newly diagnosed myeloma in a patient who is a candidate for autologous stem cell transplantation (ASCT). Bortezomib, lenalidomide, dexamethasone (VRD) has been studied in two randomized trials as first-line therapy. In one of these trials, VRD demonstrated improved overall survival compared with lenalidomide plus dexamethasone (Rd). By contrast, phase III data with overall survival differences are not available for other bortezomib-containing regimens compared with modern lenalidomide-containing regimens. Carfilzomib-lenalidomide-dexamethasone (KRD) is an alternative promising regimen but has only been evaluated in small phase II studies in the frontline setting. More data are needed before this regimen can be recommended to standard risk patients with newly diagnosed myeloma. A phase III trial comparing VRD and KRD is ongoing.
我们回顾了适合接受自体干细胞移植（ASCT）的新诊断骨髓瘤患者的治疗方案。硼替佐米、来那度胺、地塞米松（VRD）已在两项随机试验中作为一线治疗方案进行了研究。在其中一项试验中，与来那度胺加地塞米松（Rd）相比，VRD显示出总生存期有所改善。相比之下，与含现代来那度胺的方案相比，其他含硼替佐米方案的总生存期差异的III期数据尚不可用。卡非佐米-来那度胺-地塞米松（KRD）是另一种有前景的方案，但仅在一线治疗的小型II期研究中进行了评估。在将该方案推荐给新诊断骨髓瘤的标准风险患者之前，还需要更多数据。一项比较VRD和KRD的III期试验正在进行中。
