Bortezomib plus dexamethasone is highly effective in relapsed and refractory myeloma patients but responses are short-lived

Alessandro Corso, Marzia Varettoni, Silvia Mangiacavalli, Patrizia Zappasodi, Gian Matteo Pica, Alessandra Algarotti, Cristiana Pascutto, Mario Lazzarino

Research output: Contribution to journalArticle

Abstract

Objectives: Bortezomib has proven to be effective as single agent in myeloma patients. Aim of this study was to evaluate the efficacy and toxicity of bortezomib in combination with dexamethasone in a cohort of multiple myeloma (MM) relapsed/refractory patients treated in a single center. Patients and Methods: In this single center study, 70 patients were treated with bortezomib alone (9) or in combination with dexamethasone (61). Results: Forty-one patients (59%) achieved at least a partial response (PR), including 7% complete response (CR), 36% very good partial response (VGPR) reaching the best response within four cycles. The duration of response was significantly longer for patients achieving CR/VGPR than for those achieving PR (7.3 vs. 3.8 months, P = 0.03). Likewise, time to progression, time to alternative treatment, and treatment free interval were significantly better for patients obtaining CR/VGPR (6.8, 9.4, 6.5 months respectively) as compared with PR (4.9, 6.3, 2 months respectively). The only dose-limiting toxicity was peripheral neuropathy (PN), which occurred in 38/70 patients (55%) and was of grade 3-4 in 12 (17%). PN led to a dose reduction or treatment discontinuation in 17 (24%) patients. Complete resolution or improvement of PN occurred in 29/38 (76%) after a median time of 100 d (range: 17-202). Conclusions: Bortezomib in combination with dexamethasone is highly effective in relapsed/refractory MM producing an impressive rate of CR/VGPR, but responses are short-lived.

Original languageEnglish
Pages (from-to)449-454
Number of pages6
JournalEuropean Journal of Haematology
Volume83
Issue number5
DOIs
Publication statusPublished - Nov 2009

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Dexamethasone
Peripheral Nervous System Diseases
Multiple Myeloma
Bortezomib
Therapeutics

Keywords

  • Bortezomib
  • Dexamethasone
  • Neuropathy
  • Relapsed/refractory myeloma

ASJC Scopus subject areas

  • Hematology

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Bortezomib plus dexamethasone is highly effective in relapsed and refractory myeloma patients but responses are short-lived. / Corso, Alessandro; Varettoni, Marzia; Mangiacavalli, Silvia; Zappasodi, Patrizia; Pica, Gian Matteo; Algarotti, Alessandra; Pascutto, Cristiana; Lazzarino, Mario.

In: European Journal of Haematology, Vol. 83, No. 5, 11.2009, p. 449-454.

Research output: Contribution to journalArticle

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abstract = "Objectives: Bortezomib has proven to be effective as single agent in myeloma patients. Aim of this study was to evaluate the efficacy and toxicity of bortezomib in combination with dexamethasone in a cohort of multiple myeloma (MM) relapsed/refractory patients treated in a single center. Patients and Methods: In this single center study, 70 patients were treated with bortezomib alone (9) or in combination with dexamethasone (61). Results: Forty-one patients (59{\%}) achieved at least a partial response (PR), including 7{\%} complete response (CR), 36{\%} very good partial response (VGPR) reaching the best response within four cycles. The duration of response was significantly longer for patients achieving CR/VGPR than for those achieving PR (7.3 vs. 3.8 months, P = 0.03). Likewise, time to progression, time to alternative treatment, and treatment free interval were significantly better for patients obtaining CR/VGPR (6.8, 9.4, 6.5 months respectively) as compared with PR (4.9, 6.3, 2 months respectively). The only dose-limiting toxicity was peripheral neuropathy (PN), which occurred in 38/70 patients (55{\%}) and was of grade 3-4 in 12 (17{\%}). PN led to a dose reduction or treatment discontinuation in 17 (24{\%}) patients. Complete resolution or improvement of PN occurred in 29/38 (76{\%}) after a median time of 100 d (range: 17-202). Conclusions: Bortezomib in combination with dexamethasone is highly effective in relapsed/refractory MM producing an impressive rate of CR/VGPR, but responses are short-lived.",
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T1 - Bortezomib plus dexamethasone is highly effective in relapsed and refractory myeloma patients but responses are short-lived

AU - Corso, Alessandro

AU - Varettoni, Marzia

AU - Mangiacavalli, Silvia

AU - Zappasodi, Patrizia

AU - Pica, Gian Matteo

AU - Algarotti, Alessandra

AU - Pascutto, Cristiana

AU - Lazzarino, Mario

PY - 2009/11

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N2 - Objectives: Bortezomib has proven to be effective as single agent in myeloma patients. Aim of this study was to evaluate the efficacy and toxicity of bortezomib in combination with dexamethasone in a cohort of multiple myeloma (MM) relapsed/refractory patients treated in a single center. Patients and Methods: In this single center study, 70 patients were treated with bortezomib alone (9) or in combination with dexamethasone (61). Results: Forty-one patients (59%) achieved at least a partial response (PR), including 7% complete response (CR), 36% very good partial response (VGPR) reaching the best response within four cycles. The duration of response was significantly longer for patients achieving CR/VGPR than for those achieving PR (7.3 vs. 3.8 months, P = 0.03). Likewise, time to progression, time to alternative treatment, and treatment free interval were significantly better for patients obtaining CR/VGPR (6.8, 9.4, 6.5 months respectively) as compared with PR (4.9, 6.3, 2 months respectively). The only dose-limiting toxicity was peripheral neuropathy (PN), which occurred in 38/70 patients (55%) and was of grade 3-4 in 12 (17%). PN led to a dose reduction or treatment discontinuation in 17 (24%) patients. Complete resolution or improvement of PN occurred in 29/38 (76%) after a median time of 100 d (range: 17-202). Conclusions: Bortezomib in combination with dexamethasone is highly effective in relapsed/refractory MM producing an impressive rate of CR/VGPR, but responses are short-lived.

AB - Objectives: Bortezomib has proven to be effective as single agent in myeloma patients. Aim of this study was to evaluate the efficacy and toxicity of bortezomib in combination with dexamethasone in a cohort of multiple myeloma (MM) relapsed/refractory patients treated in a single center. Patients and Methods: In this single center study, 70 patients were treated with bortezomib alone (9) or in combination with dexamethasone (61). Results: Forty-one patients (59%) achieved at least a partial response (PR), including 7% complete response (CR), 36% very good partial response (VGPR) reaching the best response within four cycles. The duration of response was significantly longer for patients achieving CR/VGPR than for those achieving PR (7.3 vs. 3.8 months, P = 0.03). Likewise, time to progression, time to alternative treatment, and treatment free interval were significantly better for patients obtaining CR/VGPR (6.8, 9.4, 6.5 months respectively) as compared with PR (4.9, 6.3, 2 months respectively). The only dose-limiting toxicity was peripheral neuropathy (PN), which occurred in 38/70 patients (55%) and was of grade 3-4 in 12 (17%). PN led to a dose reduction or treatment discontinuation in 17 (24%) patients. Complete resolution or improvement of PN occurred in 29/38 (76%) after a median time of 100 d (range: 17-202). Conclusions: Bortezomib in combination with dexamethasone is highly effective in relapsed/refractory MM producing an impressive rate of CR/VGPR, but responses are short-lived.

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KW - Neuropathy

KW - Relapsed/refractory myeloma

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