TY - JOUR
T1 - Bortezomib, doxorubicin and dexamethasone in advanced multiple myeloma
AU - Palumbo, A.
AU - Gay, F.
AU - Bringhen, S.
AU - Falcone, A.
AU - Pescosta, N.
AU - Callea, V.
AU - Caravita, T.
AU - Morabito, F.
AU - Magarotto, V.
AU - Ruggeri, M.
AU - Avonto, I.
AU - Musto, P.
AU - Cascavilla, N.
AU - Bruno, B.
AU - Boccadoro, M.
PY - 2008/6
Y1 - 2008/6
N2 - Background: Bortezomib has shown significant activity in myeloma. In this multicenter trial, we assessed for the first time the combination of bortezomib, doxorubicin and low-dose dexamethasone (PAd) in the treatment of relapsed/refractory myeloma. Patients and methods: Sixty-four patients were treated for a median of four 28-day cycles (1-6). Bortezomib was given at 1.3 mg/m2 (days 1, 4, 8, 11) and dexamethasone at 40 mg (days 1-4); 34 patients receive doxorubicin at 20 mg/m2 (days 1, 4) while 30 patients pegylated liposomal doxorubicin at 30 mg/m2 (day 1). Results: Fifty-eight percent of patients had undergone prior autologous transplantation, 70% prior anthracycline and 27% prior bortezomib-based regimens. Forty-three patients (67%) achieved at least a partial response including 16 (25%) with at least a very good partial response. One-year event-free survival was 34% after PAd and 31% after the previous line of therapy (hazard ratio 1.20, 95% confidence interval 0.76-1.90, P = 0.43). One-year overall survival from the start of PAd was 66%. Grade 3-4 toxic effects included thrombocytopenia (48%), neutropenia (36%), infections (15%), anemia (13%), gastrointestinal disturbances (11%) and peripheral neuropathy (10%). Two patients had grade 3-4 cardiac heart failure. Conclusions: PAd is an active salvage therapy with manageable toxicity in patients with relapsed/refractory myeloma.
AB - Background: Bortezomib has shown significant activity in myeloma. In this multicenter trial, we assessed for the first time the combination of bortezomib, doxorubicin and low-dose dexamethasone (PAd) in the treatment of relapsed/refractory myeloma. Patients and methods: Sixty-four patients were treated for a median of four 28-day cycles (1-6). Bortezomib was given at 1.3 mg/m2 (days 1, 4, 8, 11) and dexamethasone at 40 mg (days 1-4); 34 patients receive doxorubicin at 20 mg/m2 (days 1, 4) while 30 patients pegylated liposomal doxorubicin at 30 mg/m2 (day 1). Results: Fifty-eight percent of patients had undergone prior autologous transplantation, 70% prior anthracycline and 27% prior bortezomib-based regimens. Forty-three patients (67%) achieved at least a partial response including 16 (25%) with at least a very good partial response. One-year event-free survival was 34% after PAd and 31% after the previous line of therapy (hazard ratio 1.20, 95% confidence interval 0.76-1.90, P = 0.43). One-year overall survival from the start of PAd was 66%. Grade 3-4 toxic effects included thrombocytopenia (48%), neutropenia (36%), infections (15%), anemia (13%), gastrointestinal disturbances (11%) and peripheral neuropathy (10%). Two patients had grade 3-4 cardiac heart failure. Conclusions: PAd is an active salvage therapy with manageable toxicity in patients with relapsed/refractory myeloma.
KW - Bortezomib
KW - Myeloma
KW - Relapse
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U2 - 10.1093/annonc/mdn018
DO - 10.1093/annonc/mdn018
M3 - Article
C2 - 18326520
AN - SCOPUS:44849092180
VL - 19
SP - 1160
EP - 1165
JO - Annals of Oncology
JF - Annals of Oncology
SN - 0923-7534
IS - 6
ER -