Jimenez-Zepeda Victor H, Duggan Peter, Neri Paola, Tay Jason, Bahlis Nizar J
Department of Medical Oncology and Hematology, Tom Baker Cancer Center, 1331 29th St, NW, Calgary, AB, T2N 4N2, Canada.
Ann Hematol. 2017 Mar;96(3):431-439. doi: 10.1007/s00277-016-2901-x. Epub 2017 Jan 10.
In multiple myeloma (MM) patients ineligible for transplant, the selection of up-front therapy needs to balance efficacy and toxicity. Recently, regimens with bortezomib, a proteasome inhibitor with anti-myeloma effects, have been reported. We aimed to evaluate the impact of different bortezomib-containing regimens (BCR) for the treatment of transplant-ineligible MM. All- consecutive patients treated with BCR at our institution from 01/05 to 02/16 were evaluated. With a median of 6 cycles, an overall response rate of 95.2, 80.9, and 76.3% was observed for patients treated with cyclophosphamide-bortezomib-dexamethasone (CyBorD), bortezomib-melphalan-prednisone (VMP), and bortezomib-dexamethasone (VD), respectively (p = 0.03). The median overall survival was similar between the three different BCR, but a trend for better progression-free survival was noted in favor of CyBorD. BCR are efficacious in the treatment of transplant-ineligible MM. Patients receiving continuous therapy (CT) exhibited better outcomes, suggesting that strategies to prevent toxicity and increase the cumulative dose are warranted.
在不符合移植条件的多发性骨髓瘤（MM）患者中，一线治疗方案的选择需要平衡疗效和毒性。最近，有报道称使用具有抗骨髓瘤作用的蛋白酶体抑制剂硼替佐米的治疗方案。我们旨在评估不同含硼替佐米方案（BCR）对治疗不符合移植条件的MM的影响。对2005年1月至2016年2月在我们机构接受BCR治疗的所有连续患者进行了评估。中位疗程为6个周期，接受环磷酰胺-硼替佐米-地塞米松（CyBorD）、硼替佐米-美法仑-泼尼松（VMP）和硼替佐米-地塞米松（VD）治疗的患者的总缓解率分别为95.2%、80.9%和76.3%（p = 0.03）。三种不同BCR方案的中位总生存期相似，但无进展生存期有倾向于CyBorD更好的趋势。BCR方案在治疗不符合移植条件的MM中有效。接受持续治疗（CT）的患者表现出更好的结果，这表明有必要采取预防毒性和增加累积剂量的策略。
