Therapeutic Effect of Bortezomib Combined with Dexamethasone and Thalidomide Regimens on Aged Patients with Multiple Myeloma_West China Medical Journal

Authors：

 ZHANGMing-hui ¹ ,  SUNYi ¹ , ZHANGJun-qi ² , FENGHuai-zhi ¹ , LUHai-bo ³ , FANGHong-yang ⁴ , YUELun-li ¹ , ZHONGGuo-cheng ¹ , FUXiao-ming ⁴

1. Department of Hematology and Oncology, Hosptial 452 of PLA, Chengdu, Sichuan 610021, P. R. China;
2. Department of Cadre and Air-force Service, Hosptial 452 of PLA, Chengdu, Sichuan 610021, P. R. China;
3. Department of Pharmacy, Hosptial 452 of PLA, Chengdu, Sichuan 610021, P. R. China;
Department of Medical imaging, Hosptial 452 of PLA, Chengdu, Sichuan 610021, P. R. China;

Corresponding author：

SUNYi, Email: yi_sun307@163.com

Keywords：

Aged; Multiple myeloma; Bortezomib; Chemotherapy

DOI：

10.7507/1002-0179.20140182

Video：

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Objective To investigate the efficacy and safety of bortezomib combined with dexamethasone and thalidomide regimens on aged patients with multiple myeloma. Methods A total of 166 multiple myeloma patients were selected between January 2009 and June 2013; all patients were assigned to regimens of T-VD or T-VAD named T-VD group or T-VAD group (with 25 patients in T-VD group and 29 in T-VAD group). Efficacies and toxicities were analyzed and compared after two cycles. Results Overall response rate (OR) in T-VD group was 84.0%; there was 6 patients achieved complete response (OR) or very good partial response (VGPR) (24.0%). However, Overall response rate (OR) in T-VAD group was 48.3%; there was only one patient achieved CR or VGPR (3.4%); significant difference between two groups was found (χ²=7.513, P<0.05). The major adverse reactions were debilitation, nausea, vomiting, myelo-suppression, cardiac toxicity, and peripheral neuropathy. There were highest incidence of nausea and vomiting in T-VAD group compared to T-VD group (χ²=5.794, P<0.05). Conclusion Bortezomib combined with dexamethasone and thalidomide regimens is effective and safe, which can be widely used for aged patients with multiple myeloma.

Citation： ZHANGMing-hui, SUNYi, ZHANGJun-qi, FENGHuai-zhi, LUHai-bo, FANGHong-yang, YUELun-li, ZHONGGuo-cheng, FUXiao-ming. Therapeutic Effect of Bortezomib Combined with Dexamethasone and Thalidomide Regimens on Aged Patients with Multiple Myeloma. West China Medical Journal, 2014, 29(4): 603-606. doi: 10.7507/1002-0179.20140182 Copy

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13.	Sonneveld P, Schmidt-Wolf IG, Van der Holt B, et al. Bortezomib induction and maintenance treatment in patients with newly diagnosed multiple myeloma:results of the randomized phaseⅢ HOVON-65/GMMG-HD4 trial[J]. J Clin Oncol, 2012, 30(24):2946-2955.
14.	Cavo M, Tacchetti P, Patriarca F, et al. Bortezomib with thalidomide plus dexamethasone compared with thalidomide plus dexamethasone as induction therapy before, and consolidation therapy after, double autologous stem-cell transplantation in newly diagnosed multiple myeloma:a randomised phase 3 study[J]. Lancet, 2010, 376(9758):2075-2085.
15.	Kaufman JL, Nooka A, Vrana M, et al. Bortezomib, thalidomide, and dexamethasone as induction therapy for patients with symptomatic multiple myeloma:a retrospective study[J]. Cancer, 2010, 116(13):3143-3151.
16.	Reeder CB, Reece DE, Kukreti V, et al. Once-versus twice-weekly bortezomib induction therapy with CyBorD in newly diagnosed multiple myeloma[J]. Blood, 2010, 115(16):3416-3417.
17.	Harousseau JL, Attal M, Avet-Loiseau H, et al. Bortezomib plus dexamethasone is superior to vincristine plus doxorubicin plus dexamethasone as induction treatment prior to autologous stem-cell transplantation in newly diagnosed multiple myeloma:results of the IFM 2005-01 phaseⅢ trial[J]. J Clin Oncol, 2010, 28(30):4621-4629.

1. Rossi M, Di Martino MT, Morelli E, et al. Molecular targets for the treatment of multiple myeloma[J]. Curr Cancer Drug Targets, 2012, 12(7):757-767.
2. Schecter J, Lentzsch S. Multiple myeloma:defining the high-risk patient and determining the optimal treatment strategy[J]. Curr Hematol Malig Rep, 2013, 8(4):277-283.
3. 张之南, 沈悌. 血液病诊断及疗效标准[M]. 3版. 北京:科学出版社, 2007:232-235.
4. Greipp PR, San Miguel J, Durie BG, et al. International staging system for multiple myeloma[J]. J Clin Oncol, 2005, 23(15):3412-3420.
5. Durie BG, Harousseau JL, Miguel JS, et al. International uniform response criteria for multiple myeloma[J]. Leukemia, 2006, 20(9):1467-1473.
6. Siegel R, Ma J, Zou Z, et al. Cancer statistics, 2014[J]. CA Cancer J Clin, 2014, 64(1):9-29.
7. 黄仲夏. 多发性骨髓瘤的诊治进展[J]. 临床药物治疗杂志, 2013, 9(5):4-7.
8. Rajkumar SV. Multiple myeloma:2013 update on diagnosis, risk-stratification, and management[J]. Am J Hematol, 2013, 88(3):226-235.
9. Adams J. The proteasome:a suitable antineoplastic target[J]. Nat Rev Cancer, 2004, 4(5):349-360.
10. Boccadoro M, Morgan G, Cavenagh J. Preclinical evaluation of the proteasome inhibitor bortezomib in cancer therapy[J]. Cancer Cell Int, 2005, 5(1):18.
11. Roccaro AM, Vacca A, Ribatti D, et al. Bortezomib in the treatment of cancer[J]. Recent Pat Anticancer Drug Discov, 2006, 1(3):397-403.
12. Mitsiades N, Mitsiades CS, Richardson PG, et al. The proteasome inhibitor PS-341 potentiates sensitivity of multiple myeloma cells to conventional chemotherapeutic agents:therapeutic applications[J].Blood, 2003, 101(6):2377-2380.
13. Sonneveld P, Schmidt-Wolf IG, Van der Holt B, et al. Bortezomib induction and maintenance treatment in patients with newly diagnosed multiple myeloma:results of the randomized phaseⅢ HOVON-65/GMMG-HD4 trial[J]. J Clin Oncol, 2012, 30(24):2946-2955.
14. Cavo M, Tacchetti P, Patriarca F, et al. Bortezomib with thalidomide plus dexamethasone compared with thalidomide plus dexamethasone as induction therapy before, and consolidation therapy after, double autologous stem-cell transplantation in newly diagnosed multiple myeloma:a randomised phase 3 study[J]. Lancet, 2010, 376(9758):2075-2085.
15. Kaufman JL, Nooka A, Vrana M, et al. Bortezomib, thalidomide, and dexamethasone as induction therapy for patients with symptomatic multiple myeloma:a retrospective study[J]. Cancer, 2010, 116(13):3143-3151.
16. Reeder CB, Reece DE, Kukreti V, et al. Once-versus twice-weekly bortezomib induction therapy with CyBorD in newly diagnosed multiple myeloma[J]. Blood, 2010, 115(16):3416-3417.
17. Harousseau JL, Attal M, Avet-Loiseau H, et al. Bortezomib plus dexamethasone is superior to vincristine plus doxorubicin plus dexamethasone as induction treatment prior to autologous stem-cell transplantation in newly diagnosed multiple myeloma:results of the IFM 2005-01 phaseⅢ trial[J]. J Clin Oncol, 2010, 28(30):4621-4629.

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Therapeutic Effect of Bortezomib Combined with Dexamethasone and Thalidomide Regimens on Aged Patients with Multiple Myeloma

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