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"Short course" bortezomib plus melphalan and prednisone as induction prior to transplant or as frontline therapy for nontransplant candidates in patients with previously untreated multiple myeloma.

Publication ,  Journal Article
Gasparetto, C; Gockerman, JP; Diehl, LF; de Castro, CM; Moore, JO; Long, GD; Horwitz, ME; Keogh, G; Chute, JP; Sullivan, KM; Neuwirth, R ...
Published in: Biol Blood Marrow Transplant
January 2010

The purpose of this study was to evaluate the efficacy and safety of short-course bortezomib, melphalan, prednisone (VMP) in previously untreated multiple myeloma as frontline therapy for transplant-ineligible patients and induction prior to autologous stem cell transplantation (ASCT). Patients received up to 6 28-day cycles of bortezomib 1.3 mg/m(2), days 1, 4, 8, and 11, plus melphalan 6 mg/m(2) and prednisone 60 mg/m(2), days 1-7. After 2-6 cycles, eligible and consenting patients could proceed to ASCT. Responses were assessed by International Uniform Response Criteria. The primary endpoint was complete response (CR) rate with VMP. Forty-five patients were enrolled. Among 44 evaluable patients, response rate was 95%, including 18% >or=CR (9% stringent CR), 27% very good partial responses (VGPR), and 50% partial responses (PR). Twenty patients proceeded to ASCT. Stem cell collection was successful in all; median yield was 5.6 x 10(6) CD34(+) cells/kg. Posttransplant response rates were 30% >or=CR (10% stringent CR), 65% VGPR, and 5% PR. After median follow-up of 14.0/14.6 months, median time to progression and progression-free survival were both 19.8/27.9 months in non-ASCT/ASCT patients. Seven patients have died; 1-year survival rates were 82%/95% in non-ASCT/ASCT patients. The most common grade 3/4 toxicities were thrombocytopenia (20%), neutropenia (28%), and infection (9%). Peripheral neuropathy grade 2-4 was the most common nonhematopoietic side effect occurring 17 patients (38%), although it was typically reversible, and only 5 patients (11%) discontinued therapy as a result of it. Short-course VMP is highly effective and generally well tolerated, both as initial treatment in non-ASCT patients and induction prior to ASCT. VMP did not negatively affect stem cell collection. Longer follow-up and prospective phase III trials are required to validate these initial observations.

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Published In

Biol Blood Marrow Transplant

DOI

EISSN

1523-6536

Publication Date

January 2010

Volume

16

Issue

1

Start / End Page

70 / 77

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplantation, Autologous
  • Statistics as Topic
  • Pyrazines
  • Prednisone
  • Peripheral Blood Stem Cell Transplantation
  • Multiple Myeloma
  • Middle Aged
  • Melphalan
  • Male
 

Citation

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Gasparetto, C., Gockerman, J. P., Diehl, L. F., de Castro, C. M., Moore, J. O., Long, G. D., … Rizzieri, D. (2010). "Short course" bortezomib plus melphalan and prednisone as induction prior to transplant or as frontline therapy for nontransplant candidates in patients with previously untreated multiple myeloma. Biol Blood Marrow Transplant, 16(1), 70–77. https://doi.org/10.1016/j.bbmt.2009.08.017
Gasparetto, Cristina, Jon P. Gockerman, Louis F. Diehl, Carlos M. de Castro, Joseph O. Moore, Gwynn D. Long, Mitchell E. Horwitz, et al. “"Short course" bortezomib plus melphalan and prednisone as induction prior to transplant or as frontline therapy for nontransplant candidates in patients with previously untreated multiple myeloma.Biol Blood Marrow Transplant 16, no. 1 (January 2010): 70–77. https://doi.org/10.1016/j.bbmt.2009.08.017.
Gasparetto, Cristina, et al. “"Short course" bortezomib plus melphalan and prednisone as induction prior to transplant or as frontline therapy for nontransplant candidates in patients with previously untreated multiple myeloma.Biol Blood Marrow Transplant, vol. 16, no. 1, Jan. 2010, pp. 70–77. Pubmed, doi:10.1016/j.bbmt.2009.08.017.
Gasparetto C, Gockerman JP, Diehl LF, de Castro CM, Moore JO, Long GD, Horwitz ME, Keogh G, Chute JP, Sullivan KM, Neuwirth R, Davis PH, Sutton LM, Anderson RD, Chao NJ, Rizzieri D. "Short course" bortezomib plus melphalan and prednisone as induction prior to transplant or as frontline therapy for nontransplant candidates in patients with previously untreated multiple myeloma. Biol Blood Marrow Transplant. 2010 Jan;16(1):70–77.
Journal cover image

Published In

Biol Blood Marrow Transplant

DOI

EISSN

1523-6536

Publication Date

January 2010

Volume

16

Issue

1

Start / End Page

70 / 77

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplantation, Autologous
  • Statistics as Topic
  • Pyrazines
  • Prednisone
  • Peripheral Blood Stem Cell Transplantation
  • Multiple Myeloma
  • Middle Aged
  • Melphalan
  • Male