Maintenance therapy with bortezomib plus thalidomide or bortezomib plus prednisone in elderly multiple myeloma patients included in the GEM2005MAS65 trial

[EN]Maintenance therapy has become a hot field in myeloma, and it may be particularly relevant in elderly patients because the major benefit results from the initial therapy. We report the results of a randomized comparison of maintenance with bortezomib plus thalidomide (VT) or prednisone (VP) in 1...

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Detalles Bibliográficos
Autores: Mateos Manteca, María Victoria, Oriol, Albert, Martínez-López, Joaquín, Gutiérrez Gutiérrez, Norma Carmen, Teruel, Ana-Isabel, López de la Guía, Ana, López, Javier, Bengoechea, Enrique, Pérez, Montserrat, Polo, Marta, Palomera, Luis, De Arriba, Felipe, González, Yolanda, Hernández, José-Mariano, Granell, Miquel, Bello, José-Luis, Bargay, Joan, Peñalver, Francisco-Javier, Ribera, José-María, Martín-Mateos, María-Luisa, García Sanz, Ramón, Lahuerta, Juan José, Bladé, Joan, San Miguel Izquierdo, Jesús Fernando
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2012
País:España
Institución:Universidad de Salamanca (USAL)
Repositorio:GREDOS. Repositorio Institucional de la Universidad de Salamanca
OAI Identifier:oai:gredos.usal.es:10366/154315
Acceso en línea:http://hdl.handle.net/10366/154315
Access Level:acceso abierto
Palabra clave:Mieloma múltiple
Chromosome Aberrations
Aged
Boronic Acids
Follow-Up Studies
Humans
Pyrazines
Antineoplastic Combined Chemotherapy Protocols
Prognosis
Multiple Myeloma
Maintenance Chemotherapy
Thalidomide
In Situ Hybridization
Prednisone
Remission Induction
Survival Rate
talidomida
protocolos de quimioterapia antineoplásica combinada
humanos
inducción de remisión
anciano
estudios de seguimiento
mieloma múltiple
prednisona
tasa de supervivencia
pronóstico
ácidos borónicos
hibridación in situ
quimioterapia de mantenimiento
aberraciones cromosómicas
piracinas
Descripción
Sumario:[EN]Maintenance therapy has become a hot field in myeloma, and it may be particularly relevant in elderly patients because the major benefit results from the initial therapy. We report the results of a randomized comparison of maintenance with bortezomib plus thalidomide (VT) or prednisone (VP) in 178 elderly untreated myeloma patients who had received 6 induction cycles with bortezomib plus either melphalan and prednisone or thalidomide and prednisone. The complete response (CR) rate increased from 24% after induction up to 42%, higher for VT versus VP (46% vs 39%). Median progression-free survival (PFS) was superior for VT (39 months) compared with VP (32 months) and overall survival (OS) was also longer in VT patients compared with VP (5-year OS of 69% and 50%, respectively) but the differences did not reach statistical significance. CR achievement was associated with a significantly longer PFS (P < .001) and 5-year OS (P < .001). The incidence of G3-4 peripheral neuropathy was 9% for VT and 3% for VP. Unfortunately, this approach was not able to overcome the adverse prognosis of cytogenetic abnormalities. In summary, these maintenance regimens result in a significant increase in CR rate, remarkably long PFS, and acceptable toxicity profile. The trial is registered at www.clinicaltrials.gov as NCT00443235.

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