Bortezomib, thalidomide, dexamethasone induction therapy followed by melphalan, prednisolone, thalidomide consolidation therapy as a first line of treatment for patients with multiple myeloma who are non-transplant candidates: results of the Korean Multiple Myeloma Working Party (KMMWP)
- Hyeon-Seok Eom; Yeo-Kyeoung Kim; Joo-Seop Chung; Kihyun Kim; Hyo Jung Kim; Ho Young Kim & Jong-Youl Jin; Young-Rok Do; Suk-Joong Oh; Cheolwon Suh; Chu-Myong Seong; Chul Soo Kim; Dong Soon Lee; Jae Hoon Lee
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- Bortezomib (VELCADE®), thalidomide and
dexamethasone (VTD), as well as melphalan, prednisolone,
and thalidomide (MPT) therapy, are highly effective in
patients with multiple myeloma. We evaluated the responses
and survival times of 35 patients treated with VTD followed
by MPT. All patients were newly diagnosed and nontransplantation
candidates. Patients received six cycles of
VTD, which were followed by eight cycles of MPT.
Approximately 97% of patients exhibited early responses
to therapy, as early as the second cycle of VTD. Thirty
percent of the responses were high quality, which was
defined as a complete response (CR), a near-CR or a verygood partial response. High-risk patients were defined as
patients with any of the following aberrations: del(13),
t(4;14), or del(17p). The remaining patients were defined as
standard risk. Eleven high-risk patients showed 100%
response rates, including 91% high-quality responses. In
contrast, 13 standard-risk patients exhibited 92% response
rates, including 61% high-quality responses. The overall
2-year survival rates were 60% in high-risk patients and 85%
in standard-risk patients, which was not significantly
different. As a first-line therapy, VTD followed by MPT
has the potential to provide high-quality responses with
durable remission among elderly and high-risk patients
(clinicaltrials.gov identifier: NCT00320476).
Keywords Multiple myeloma . Bortezomib . Thalidomide .
High-risk . Elderly patients
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