TY - JOUR
T1 - Incorporating bortezomib into upfront treatment for multiple myeloma
T2 - Early results of total therapy 3
AU - Barlogie, Bart
AU - Anaissie, Elias
AU - Van Rhee, Frits
AU - Haessler, Jeffrey
AU - Hollmig, Klaus
AU - Pineda-Roman, Mauricio
AU - Cottler-Fox, Michele
AU - Mohiuddin, Abid
AU - Alsayed, Yazan
AU - Tricot, Guido
AU - Bolejack, Vanessa
AU - Zangari, Maurizio
AU - Epstein, Joshua
AU - Petty, Nathan
AU - Steward, Douglas
AU - Jenkins, Bonnie
AU - Gurley, Jennifer
AU - Sullivan, Ellen
AU - Crowley, John
AU - Shaughnessy, John D.
PY - 2007/7
Y1 - 2007/7
N2 - Total therapy 3 incorporated bortezomib into a melphalan-based tandem transplant regimen for 303 newly diagnosed patients with myeloma. Induction chemotherapy prior to and consolidation chemotherapy after transplants each consisted of two cycles of VTD-PACE (bortezomib, thalidomide, dexamethasone and 4-d continuous infusions of cis-platin, doxorubicin, cyclophosphamide, etoposide); 3-year maintenance comprised monthly cycles of VTD in the first and TD in the remaining years. The median age was 59 years (age >64 years, 28%). A minimum of 20 × 106 CD34 cells/kg was collected in 87% of patients; 83% completed both transplants, and only 5% suffered a treatment-related death. At 24 months, 83% had achieved near-complete remission, which was sustained in 88% at 2 years from its onset. With a median follow-up of 20 months, 2-year estimates of event-free and overall survival were 84% and 86% respectively. The 44 patients who experienced an event more often had a high-risk gene array profile, cytogenetic abnormalities and indicators of high lactate dehydrogenase, beta-2-microglobulin, creatinine and International Staging System stage. Toxicities of grade > 2 included thrombo-embolic events in 27% and peripheral neuropathy in 12%. Results of this phase-2 study demonstrated that bortezomib could be safely combined with multi-agent chemotherapy, effecting near-complete remission status and 2-year survival rates in more than 80% of patients.
AB - Total therapy 3 incorporated bortezomib into a melphalan-based tandem transplant regimen for 303 newly diagnosed patients with myeloma. Induction chemotherapy prior to and consolidation chemotherapy after transplants each consisted of two cycles of VTD-PACE (bortezomib, thalidomide, dexamethasone and 4-d continuous infusions of cis-platin, doxorubicin, cyclophosphamide, etoposide); 3-year maintenance comprised monthly cycles of VTD in the first and TD in the remaining years. The median age was 59 years (age >64 years, 28%). A minimum of 20 × 106 CD34 cells/kg was collected in 87% of patients; 83% completed both transplants, and only 5% suffered a treatment-related death. At 24 months, 83% had achieved near-complete remission, which was sustained in 88% at 2 years from its onset. With a median follow-up of 20 months, 2-year estimates of event-free and overall survival were 84% and 86% respectively. The 44 patients who experienced an event more often had a high-risk gene array profile, cytogenetic abnormalities and indicators of high lactate dehydrogenase, beta-2-microglobulin, creatinine and International Staging System stage. Toxicities of grade > 2 included thrombo-embolic events in 27% and peripheral neuropathy in 12%. Results of this phase-2 study demonstrated that bortezomib could be safely combined with multi-agent chemotherapy, effecting near-complete remission status and 2-year survival rates in more than 80% of patients.
KW - Autotransplant
KW - Bortezomib
KW - Myeloma
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UR - http://www.scopus.com/inward/citedby.url?scp=34250878387&partnerID=8YFLogxK
U2 - 10.1111/j.1365-2141.2007.06639.x
DO - 10.1111/j.1365-2141.2007.06639.x
M3 - Article
C2 - 17593024
AN - SCOPUS:34250878387
SN - 0007-1048
VL - 138
SP - 176
EP - 185
JO - British Journal of Haematology
JF - British Journal of Haematology
IS - 2
ER -