| HOME | HELP | FEEDBACK | TABLE OF CONTENTS | ARCHIVE | SUBSCRIPTIONS |
|
|
|
||||||
|
||||||||
Multiple Myeloma |
1 Hospital Universitario de Salamanca;
2 Hospital General de Segovia
3 Hospital Universitario de Canarias
4 Hospital Lozano Blesa de Zaragoza
5 Hospital Virgen Blanca de León
6 Hospital Clínico Universitario San Carlos de Madrid
7 Hospital 12 de Octubre de Madrid
8 Hospital La Fe de Valencia
9 Hospital Clinico Universitario de Valencia
10 Hospital Santa Creu i Sant Pau de Barcelona
11 Hospital Sont Llatzer de Palma de Mallorca
12 Hospital Dr Pesset de Alicante
13 Hospital la Princesa de Madrid
14 Hospital Morales Messeguer de Murcia
15 Hospital Germans Trials I Pujol de Badalona
16 Hospital Central de Asturias
17 Hospital Ramón y Cajal de Madrid
18 Hospital Clinic. IDIBAPS. Barcelona, Spain
19 Clínica Universitaria de Navarra
* PETHEMA/GEM (Grupo Español de MM), Spain
+ University Hospital, CIC/CSIC Salamanca, Spain
20 Millennium Pharmaceuticals, Inc., Cambridge, MA, USA and
21 Johnson & Johnson Pharmaceutical Research & Development, Beerse, Belgium
Correspondence: Jesús F. San Miguel, Paseo San Vicente 58-182, 37007 Salamanca, Spain. E-mail:sanmigiz{at}usal.es
Background: New treatment options offering enhanced activity in elderly, newly diagnosed patients with multiple myeloma are required. One strategy is to combine melphalan and prednisone with novel agents. We previously reported an 89% response rate, including 32% complete responses and 11% near complete responses, in our phase 1/2 study of bortezomib plus melphalan and prednisone (VMP) in 60 newly diagnosed multiple myeloma patients with a median age of 75 years. Here, we report updated time-to-events data and the impact of poor prognosis factors on outcome.
Design and Methods: Updated analyses of time to biochemical progression and overall survival with VMP were conducted, and compared with those of historical controls treated with melphalan and prednisone. A univariate analysis was performed to evaluate the influence of known prognostic factors on the time to progression.
Results: After a median follow-up of 26 months, the median time to progression with VMP was 27.2 months, compared with 20.0 months with melphalan plus prednisone. The median overall survival with VMP was not reached versus 26 months with melphalan and prednisone; the survival rate at 38 months was 85% versus 38%, respectively. Time to progression was not significantly affected by elevated β2-microglobulin or lactate dehydrogenase levels, advanced age, or cytogenetic abnormalities, but was shorter in patients with albumin <3 g/dL, Karnofsky performance status 
70%, bone marrow plasma cell infiltration 
40%, and, particularly, high plasma cell proliferative activity (2.5% S-phase cells).
Conclusions: VMP is highly active and well tolerated in elderly patients with newly diagnosed muktiple myeloma, with 85% of patients alive at 3 years. Moreover, VMP may overcome the poor prognostic impact of various factors, particularly cytogenetic abnormalities.
Key words: multiple myeloma, bortezomib, melphalan, prednisone, elderly, clinical trial, first-line.
This article has been cited by other articles:
|
|
 |
|
  M. Rotta, B. E. Storer, F. Sahebi, J. A. Shizuru, B. Bruno, T. Lange, E. D. Agura, P. A. McSweeney, M. A. Pulsipher, P. Hari, et al. Long-term outcome of patients with multiple myeloma after autologous hematopoietic cell transplantation and nonmyeloablative allografting Blood, April 2, 2009; 113(14): 3383 - 3391. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. A Saad, M. Sharma, and G. M Higa Treatment of Multiple Myeloma in the Targeted Therapy Era Ann. Pharmacother., February 1, 2009; 43(2): 329 - 338. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | TABLE OF CONTENTS | ARCHIVE | SUBSCRIPTIONS |
