3 years ago

Efficacy of VDT PACE-like Regimens in Treatment of Relapsed/Refractory Multiple Myeloma

Morie A. Gertz, John A. Lust, Yi Lisa Hwa, Angela Dispenzieri, Preet Paul Singh, Nelson Leung, Robert A. Kyle, Steven R. Zeldenrust, Martha Q. Lacy, Wilson I. Gonsalves, Yi Lin, Miriam Hobbs, Arjun Lakshman, Prashant Kapoor, Suzanne R. Hayman, S. Vincent Rajkumar, Ronald S. Go, Amie L. Fonder, Stephen J. Russell, Rahma Warsame, Taxiarchis Kourelis, David Dingli, Francis K. Buadi, Shaji K. Kumar
Experience with intensive chemotherapy for relapsed/refractory multiple myeloma (RRMM) using VDT PACE regimen and its modifications (VDT PACE-like regimens-VPLRs) outside TOTAL THERAPY trials is limited. We analyzed the outcomes of 141 patients with RRMM who received VPLRs at our center between 2006 and 2017 in an intent-to-treat analysis. Median age was 59.7 years and 66.7% of patients were male. A median of 2.2 years (range, 0.02-11.4) separated diagnosis of myeloma and inititation of VPLR. High-risk cytogenetics were present in 52.4% patients. Patients received a median of 4 (range, 1-14) prior therapies including stem cell transplant (SCT) in 66.7% patients. Ninety five (67.4%) patients received VDT PACE, 20 (14.2%) received VD PACE and 26 (18.4) received other VPLRs. Patients received a median of 1 cycle (range, 1-9) of VPLR. We observed ≥minimal response in 68.4%, ≥partial response (PR) in 54.4% and ≥very good PR in 10.3% patients. Median progression-free survival was 3.1 months (95%CI, 1.9-3.9) and median overall survival (OS) was 8.1 months (CI, 6.2-9.9). One-hundred and sixteen (82.3%) patients received some therapy after VPLR; 71 (61.2%) received systemic chemotherapy, while 45 (38.8%) underwent SCT. Median OS for those who received SCT after VPLR was 15.1 months (CI, 10.3-20.8). Age ≥60 years [hazard ratio (HR)- 2.3 (CI, 1.4-3.7); p<0.01] and R-ISS III stage [HR- 2.4 (CI, 1.3-4.0); p<0.01] predicted shorter OS in patients receiving VPLR. VPLRs are effective in heavily pre-treated RRMM. In fit patients, SCT can be used to consolidate the response to VPLR. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1002/ajh.24954

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.