Duarte Patricio Jose, Schutz Natalia Paola, Ochoa Paola, Yantorno Sebastian, Orlando Sergio, Lopresti Sergio, Zabaljauregui Soledad, Aizpurua Florencia, Shanley Claudia, Giannini Elvira, Garate Gonzalo, Foncuberta Cecilia, Milone Jorge, Riveros Dardo, Fantl Dorotea
CEMIC, Sección Hematología, Buenos Aires, Argentina.
Hospital Italiano De Buenos Aires, Sección Hematología, Argentina.
Expert Rev Hematol. 2021 Mar;14(3):315-322. doi: 10.1080/17474086.2021.1886073. Epub 2021 Mar 1.
We compared the efficacy of lenalidomide-dexamethasone (Rd) based treatments for relapsed/refractory multiple myeloma patients (pts), in a real-world setting. In addition, we evaluated adverse events (AE), progression-free survival (PFS) and overall survival (OS).
In our retrospective, multicentric study, 156 pts with RRMM were included. 74/156 pts (47%) were refractory to bortezomib (V) and 43/156 (27%) pts to lenalidomide (R), with 24/156 (15%) of pts double refractory. Eighty-six pts (55%) received Rd with carfilzomib (KRd), 30 pts (19%) bortezomib (VRd), 30 pts (19%) daratumumab (DRd), and 10 pts (6%) ixazomib (IRd).
The overall response (ORR) (≥ partial response) for the entire cohort was 71%, with a very good partial response rate or better (≥VGPR) of 35%. We found no significant differences in CR or ≥VGRP rates between treatments (p:0.229). Regardless of the combination received, those patients who achieved CR had significantly improved PFS (p: 0.007). The most frequent cause of treatment discontinuation was disease progression in 55/156 pts (35%). 8 pts (5%) discontinued treatment due to treatment-related adverse events (AE).
This is the first report of Rd combinations for the treatment of RRMM in Latin America. All combinations proved to be effective with an acceptable toxicity.
我们在真实世界环境中比较了来那度胺-地塞米松(Rd)方案对复发/难治性多发性骨髓瘤患者的疗效。此外,我们评估了不良事件(AE)、无进展生存期(PFS)和总生存期(OS)。
在我们的回顾性多中心研究中,纳入了156例复发/难治性多发性骨髓瘤患者。156例患者中有74例(47%)对硼替佐米(V)难治,43例(27%)对来那度胺(R)难治,24例(15%)为双重难治。86例患者(55%)接受了来那度胺联合卡非佐米(KRd)治疗,30例患者(19%)接受硼替佐米(VRd)治疗,30例患者(19%)接受达雷妥尤单抗(DRd)治疗,10例患者(6%)接受伊沙佐米(IRd)治疗。
整个队列的总缓解率(ORR)(≥部分缓解)为71%,非常好的部分缓解率或更高(≥VGPR)为35%。我们发现各治疗组之间的完全缓解(CR)或≥VGPR率无显著差异(p:0.229)。无论接受何种联合治疗,达到CR的患者的PFS均有显著改善(p:0.007)。治疗中断的最常见原因是疾病进展,156例患者中有55例(35%)。8例患者(5%)因治疗相关不良事件(AE)而中断治疗。
这是拉丁美洲关于Rd联合方案治疗复发/难治性多发性骨髓瘤的首份报告。所有联合方案均证明有效且毒性可接受。