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Retrospective comparison of bortezomib-containing regimens with vincristine-doxorubicin-dexamethasone (VAD) as induction treatment prior to autologous stem cell transplantation for multiple myeloma.
Jpn J Clin Oncol. 2009 Jul; 39(7):449-55.JJ

Abstract

OBJECTIVE

Patients with multiple myeloma (MM) achieving high-quality responses, defined as a complete response (CR) and a very good partial response (VGPR) after transplant, benefit from high-dose therapy followed by autologous stem cell transplantation (ASCT). Induction pre-transplantation treatment with vincristine, doxorubicin and dexamethasone (VAD) is currently being replaced by new targeted agents with high anti-myeloma activity. The use of these novel agents may increase the CR + VGPR rate before ASCT, which may improve post-transplantation responses and survival.

METHODS

We performed a retrospective analysis of 69 patients with MM who received bortezomib-containing regimens (n = 30) or VAD (n = 39) before collection of peripheral blood stem cells and ASCT.

RESULTS

Objective response rate (at least a partial response) prior to ASCT was documented in 27 (90%) of 30 and 31 (81.6%) of evaluable 38 patients with bortezomib-containing regimens and VAD, respectively. The difference between the two groups was not significant (P = 0.494). However, the high-quality response rate with VGPR or more in the bortezomib group was significantly higher compared with the VAD group (66.7% vs. 34.2%, respectively, P = 0.006). The superiority of bortezomib-containing regimens in the high-quality response rate remained significant for only the newly diagnosed patients (n = 16, P = 0.008). The engraftment data as well as stem cell harvesting were comparable between the two groups. The major bortezomib-related toxicities were thrombocytopenias and peripheral neuropathies; toxicities of VAD were hematologic and infectious. After ASCT, the difference between the two groups did not reach the level of statistical significance with respect to progression-free survival and overall survival (P = 0.498 and 0.835, respectively).

CONCLUSIONS

The results of this retrospective comparison of bortezomib-containing regimens with the VAD as induction treatment prior to ASCT for MM provided a demonstration of the superiority of bortezomib therapy in terms of achieving a high-quality response. However, survivals following ASCT did not differ according to the induction regimens.

Authors+Show Affiliations

Department of Internal Medicine, St Mary's Hospital, The Catholic University of Korea, Youngdungpo-Gu, Seoul, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19487425

Citation

Eom, Hyeon-Seok, et al. "Retrospective Comparison of Bortezomib-containing Regimens With Vincristine-doxorubicin-dexamethasone (VAD) as Induction Treatment Prior to Autologous Stem Cell Transplantation for Multiple Myeloma." Japanese Journal of Clinical Oncology, vol. 39, no. 7, 2009, pp. 449-55.
Eom HS, Min CK, Cho BS, et al. Retrospective comparison of bortezomib-containing regimens with vincristine-doxorubicin-dexamethasone (VAD) as induction treatment prior to autologous stem cell transplantation for multiple myeloma. Jpn J Clin Oncol. 2009;39(7):449-55.
Eom, H. S., Min, C. K., Cho, B. S., Lee, S., Lee, J. W., Min, W. S., Kim, C. C., Kim, M., & Kim, Y. (2009). Retrospective comparison of bortezomib-containing regimens with vincristine-doxorubicin-dexamethasone (VAD) as induction treatment prior to autologous stem cell transplantation for multiple myeloma. Japanese Journal of Clinical Oncology, 39(7), 449-55. https://doi.org/10.1093/jjco/hyp046
Eom HS, et al. Retrospective Comparison of Bortezomib-containing Regimens With Vincristine-doxorubicin-dexamethasone (VAD) as Induction Treatment Prior to Autologous Stem Cell Transplantation for Multiple Myeloma. Jpn J Clin Oncol. 2009;39(7):449-55. PubMed PMID: 19487425.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retrospective comparison of bortezomib-containing regimens with vincristine-doxorubicin-dexamethasone (VAD) as induction treatment prior to autologous stem cell transplantation for multiple myeloma. AU - Eom,Hyeon-Seok, AU - Min,Chang-Ki, AU - Cho,Byung-Sik, AU - Lee,Seok, AU - Lee,Jong-Wook, AU - Min,Woo-Sung, AU - Kim,Chun-Choo, AU - Kim,Myungshin, AU - Kim,Yonggoo, Y1 - 2009/06/01/ PY - 2009/6/3/entrez PY - 2009/6/3/pubmed PY - 2009/7/10/medline SP - 449 EP - 55 JF - Japanese journal of clinical oncology JO - Jpn J Clin Oncol VL - 39 IS - 7 N2 - OBJECTIVE: Patients with multiple myeloma (MM) achieving high-quality responses, defined as a complete response (CR) and a very good partial response (VGPR) after transplant, benefit from high-dose therapy followed by autologous stem cell transplantation (ASCT). Induction pre-transplantation treatment with vincristine, doxorubicin and dexamethasone (VAD) is currently being replaced by new targeted agents with high anti-myeloma activity. The use of these novel agents may increase the CR + VGPR rate before ASCT, which may improve post-transplantation responses and survival. METHODS: We performed a retrospective analysis of 69 patients with MM who received bortezomib-containing regimens (n = 30) or VAD (n = 39) before collection of peripheral blood stem cells and ASCT. RESULTS: Objective response rate (at least a partial response) prior to ASCT was documented in 27 (90%) of 30 and 31 (81.6%) of evaluable 38 patients with bortezomib-containing regimens and VAD, respectively. The difference between the two groups was not significant (P = 0.494). However, the high-quality response rate with VGPR or more in the bortezomib group was significantly higher compared with the VAD group (66.7% vs. 34.2%, respectively, P = 0.006). The superiority of bortezomib-containing regimens in the high-quality response rate remained significant for only the newly diagnosed patients (n = 16, P = 0.008). The engraftment data as well as stem cell harvesting were comparable between the two groups. The major bortezomib-related toxicities were thrombocytopenias and peripheral neuropathies; toxicities of VAD were hematologic and infectious. After ASCT, the difference between the two groups did not reach the level of statistical significance with respect to progression-free survival and overall survival (P = 0.498 and 0.835, respectively). CONCLUSIONS: The results of this retrospective comparison of bortezomib-containing regimens with the VAD as induction treatment prior to ASCT for MM provided a demonstration of the superiority of bortezomib therapy in terms of achieving a high-quality response. However, survivals following ASCT did not differ according to the induction regimens. SN - 1465-3621 UR - https://www.unboundmedicine.com/medline/citation/19487425/Retrospective_comparison_of_bortezomib_containing_regimens_with_vincristine_doxorubicin_dexamethasone__VAD__as_induction_treatment_prior_to_autologous_stem_cell_transplantation_for_multiple_myeloma_ L2 - https://academic.oup.com/jjco/article-lookup/doi/10.1093/jjco/hyp046 DB - PRIME DP - Unbound Medicine ER -