A comparison of salvage infusional chemotherapy regimens for recurrent/refractory multiple myeloma

摘要: BACKGROUND Despite the impact of proteasome inhibitors and immunomodulatory agents, infusional chemotherapy regimens continue to be used for patients with multiple myeloma. To authors' knowledge, contemporary data regarding salvage are sparse, no direct comparisons. METHODS The authors performed a single-institution study comparing 3 in 107 recurrent/refractory myeloma: dexamethasone, cyclophosphamide, etoposide, cisplatin (DCEP) 52 patients; bortezomib, thalidomide, cisplatin, doxorubicin, etoposide (VTD-PACE) 22 vincristine, dexamethasone (CVAD) 33 patients. RESULTS Differences between treatment groups existed, including higher baseline creatinine treated CVAD (P<.001) greater prior use those receiving VTD-PACE (P<.001). There was significant difference response noted among regimens: 55% overall (P = .18). For intent-to-transplant population, similar percentage were successfully bridged transplant without further therapy (62%; P .9). survival observed across regimens, an median progression-free 4.5 months (95% confidence interval, 3.6-5.5 [P .8]) 8.5 6.1-11 .8]). Furthermore, there statistically clinically relevant adverse events, although suggestion fewer events DCEP. Patients intent had superior outcomes (odds ratio, 3.40; .01), (hazard 0.28; P<.001), 0.19; P<.001). CONCLUSIONS The demonstrated responses, survival, events. Given short durations disease setting, is best suited cytoreduction before more definitive administered. Cancer 2015;121:3622–3630. © 2015 American Society.