Bortezomib plus dexamethasone versus reduced-dose bortezomib, thalidomide plus dexamethasone as induction treatment before autologous stem cell transplantation in newly diagnosed multiple myeloma.

Moreau, Philippe;Avet-Loiseau, Herve;Facon, Thierry;Attal, Michel;Doyen, Chantal;et.al.
(2011) Blood — Vol. 118, n° 22, p. 5752-5758; quiz 5982 (2011)

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Authors
  • Moreau, Philippe
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  • Avet-Loiseau, Herve
    Author
  • Facon, Thierry
    Author
  • Attal, Michel
    Author
  • Doyen, ChantalMGD
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  • et. al.
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Abstract
The Intergroupe Francophone du Myelome conducted a randomized trial to compare bortezomib-dexamethasone (VD) as induction before high-dose therapy (HDT) and autologous stem cell transplantation (ASCT) to a combination consisting of reduced doses of bortezomib and thalidomide plus dexamethasone (vtD) in patients with multiple myeloma. Overall, a total of 199 patients were centrally randomly assigned to receive VD or vtD. After 4 cycles, the complete response (CR) rate was the same in both groups (13% in the vtD arm, 12% in the VD arm, P = .74). However, the CR plus very good partial response (VGPR) rate was significantly higher in the vtD arm (49% vs 36%, P = .05). After ASCT, the CR plus VGPR rate was significantly higher in the vtD arm (74% vs 58%, P = .02). The reduced doses of bortezomib and thalidomide translated into a reduced incidence of peripheral neuropathy (PN): grade ≥ 2 PN were reported in 34% in the VD arm versus 14% in the vtD arm (P = .001). vtD, including reduced doses of bortezomib and thalidomide, yields higher VGPR rates compared with VD and can be considered a new effective triplet combination before HDT/ASCT.
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Moreau, P., Avet-Loiseau, H., Facon, T., Attal, M., Tiab, M., Hulin, C., Doyen, C., & et al. (2011). Bortezomib plus dexamethasone versus reduced-dose bortezomib, thalidomide plus dexamethasone as induction treatment before autologous stem cell transplantation in newly diagnosed multiple myeloma. Blood, 118(22), 5752-5758; quiz 5982. https://doi.org/10.1182/blood-2011-05-355081 (Original work published 2011)