免疫调节剂作为挽救疗法治疗复发/难治性多发性骨髓瘤的 VD-PACE 结局。
Outcomes of VD-PACE With Immunomodulatory Agent as a Salvage Therapy for Relapsed/Refractory Multiple Myeloma.
机构信息
Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Medical Center, Westwood, KS.
University of Kansas Medical Center, Westwood, KS.
出版信息
Clin Lymphoma Myeloma Leuk. 2021 Feb;21(2):e220-e226. doi: 10.1016/j.clml.2020.09.002. Epub 2020 Sep 30.
BACKGROUND
Aggressive relapsed/refractory multiple myeloma (RRMM) often requires salvage cytotoxic chemotherapy. We evaluated the efficacy and toxicity of VD-PACE (bortezomib, dexamethasone, cisplatin, doxorubicin, cyclophosphamide, etoposide) with an immunomodulatory agent (IMiD) in RRMM.
PATIENTS AND METHODS
We retrospectively reviewed the effectiveness and tolerability among 30 patients with RRMM receiving ≥ 1 cycle of VD-PACE + IMiD between January 2012 to April 2019.
RESULTS
Of 30 patients, 26 (86%) had myeloma double refractory to protease inhibitors and IMiDs, and had received a median of 3 lines prior of therapy. The overall response rate was 67.7%, 13% patients experienced complete remission or better, and 13% experienced very good partial response. Median progression-free and median overall survival were 11 and 26 months, respectively. The most common grade 3 or higher adverse events were hematologic events, which were manageable.
CONCLUSION
VD-PACE + IMiD is an effective and tolerable salvage treatment for RRMM, with an impressive response rate in pretreated RRMM.
背景
侵袭性复发/难治性多发性骨髓瘤（RRMM）常需要挽救性细胞毒化疗。我们评估了 VD-PACE（硼替佐米、地塞米松、顺铂、多柔比星、环磷酰胺、依托泊苷）联合免疫调节剂（IMiD）在 RRMM 中的疗效和毒性。
患者和方法
我们回顾性分析了 2012 年 1 月至 2019 年 4 月期间 30 例接受 VD-PACE+IMiD 治疗≥1 个周期的 RRMM 患者的有效性和耐受性。
结果
30 例患者中，26 例（86%）对蛋白酶抑制剂和 IMiD 双重耐药，治疗前中位数接受了 3 线治疗。总体缓解率为 67.7%，13%的患者达到完全缓解或更好，13%的患者达到非常好的部分缓解。中位无进展生存期和中位总生存期分别为 11 个月和 26 个月。最常见的 3 级或以上不良事件为血液学事件，可控制。
结论
VD-PACE+IMiD 是 RRMM 有效且耐受良好的挽救性治疗方法，在预处理 RRMM 中具有令人印象深刻的缓解率。
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