Bortezomib, melphalan, prednisone, and thalidomide for relapsed multiple myeloma

Antonio Palumbo, Maria Teresa Ambrosini, Giulia Benevolo, Patrizia Pregno, Norbert Pescosta, Vincenzo Callea, Clotilde Cangialosi, Tommaso Caravita, Fortunato Morabito, Pellegrino Musto, Sara Bringhen, Patrizia Falco, Ilaria Avonto, Federica Cavallo, Mario Boccadoro

Research output: Contribution to journalArticle

Abstract

In multiple myeloma (MM), the addition of thalidomide or bortezomib to the standard oral melphalan/prednisone combination significantly increased response rate and event-free survival. In this multicenter phase 1/2 trial, dosing, safety, and efficacy of the 4-drug combination, bortezomib, melphalan, prednisone, and thalidomide (VMPT) was determined. Bortezomib was administered at 3 dose levels (1.0 mg/m2, 1.3 mg/m2, or 1.6 mg/m 2) on days 1, 4, 15, and 22; melphalan was given at a dose of 6 mg/m2 on days 1 through 5 and prednisone at 60 mg/m2 on days 1 through 5. Thalidomide was delivered at 50 mg on days 1 through 35. Each course was repeated every 35 days. The maximum tolerated dose of bortezomib was 1.3 mg/m2. Thirty patients with relapsed or refractory MM were enrolled; 20 patients (67%) achieved a partial response (PR) including 13 patients (43%) who achieved at least a very good PR. Among 14 patients who received VMPT as second-line treatment, the PR rate was 79% and the immunofixation-negative complete response rate 36%. The 1-year progression-free survival was 61%, and the 1-year survival from study entry was 84%. Grade 3 nonhematologic adverse events included infections (5 patients), fatigue (1), vasculitis (1), and peripheral neuropathy (2); no grade 4 toxicities were recorded. Initial results showed that VMPT is an effective salvage therapy with a very high proportion of responses. The incidence of neurotoxicities was unexpectedly low.

Original languageEnglish
Pages (from-to)2767-2772
Number of pages6
JournalBlood
Volume109
Issue number7
DOIs
Publication statusPublished - Apr 1 2007

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Melphalan
Thalidomide
Prednisone
Multiple Myeloma
Disease-Free Survival
Salvaging
Drug Combinations
Salvage Therapy
Refractory materials
Maximum Tolerated Dose
Toxicity
Peripheral Nervous System Diseases
Vasculitis
Fatigue of materials
Fatigue
Bortezomib
Safety
Survival
Incidence
Infection

ASJC Scopus subject areas

  • Hematology

Cite this

Palumbo, A., Ambrosini, M. T., Benevolo, G., Pregno, P., Pescosta, N., Callea, V., ... Boccadoro, M. (2007). Bortezomib, melphalan, prednisone, and thalidomide for relapsed multiple myeloma. Blood, 109(7), 2767-2772. https://doi.org/10.1182/blood-2006-08-042275

Bortezomib, melphalan, prednisone, and thalidomide for relapsed multiple myeloma. / Palumbo, Antonio; Ambrosini, Maria Teresa; Benevolo, Giulia; Pregno, Patrizia; Pescosta, Norbert; Callea, Vincenzo; Cangialosi, Clotilde; Caravita, Tommaso; Morabito, Fortunato; Musto, Pellegrino; Bringhen, Sara; Falco, Patrizia; Avonto, Ilaria; Cavallo, Federica; Boccadoro, Mario.

In: Blood, Vol. 109, No. 7, 01.04.2007, p. 2767-2772.

Research output: Contribution to journalArticle

Palumbo, A, Ambrosini, MT, Benevolo, G, Pregno, P, Pescosta, N, Callea, V, Cangialosi, C, Caravita, T, Morabito, F, Musto, P, Bringhen, S, Falco, P, Avonto, I, Cavallo, F & Boccadoro, M 2007, 'Bortezomib, melphalan, prednisone, and thalidomide for relapsed multiple myeloma', Blood, vol. 109, no. 7, pp. 2767-2772. https://doi.org/10.1182/blood-2006-08-042275
Palumbo A, Ambrosini MT, Benevolo G, Pregno P, Pescosta N, Callea V et al. Bortezomib, melphalan, prednisone, and thalidomide for relapsed multiple myeloma. Blood. 2007 Apr 1;109(7):2767-2772. https://doi.org/10.1182/blood-2006-08-042275
Palumbo, Antonio ; Ambrosini, Maria Teresa ; Benevolo, Giulia ; Pregno, Patrizia ; Pescosta, Norbert ; Callea, Vincenzo ; Cangialosi, Clotilde ; Caravita, Tommaso ; Morabito, Fortunato ; Musto, Pellegrino ; Bringhen, Sara ; Falco, Patrizia ; Avonto, Ilaria ; Cavallo, Federica ; Boccadoro, Mario. / Bortezomib, melphalan, prednisone, and thalidomide for relapsed multiple myeloma. In: Blood. 2007 ; Vol. 109, No. 7. pp. 2767-2772.
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AU - Pescosta, Norbert

AU - Callea, Vincenzo

AU - Cangialosi, Clotilde

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AU - Morabito, Fortunato

AU - Musto, Pellegrino

AU - Bringhen, Sara

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