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Bortezomib, lenalidomide and dexamethasone (VRd) vs carfilzomib, lenalidomide and dexamethasone (KRd) as induction therapy in newly diagnosed multiple myeloma
Lenalidomide and dexamethasone with bortezomib (VRd) or carfilzomib (KRd) are commonly used induction regimens in the U.S. This single-center, retrospective study evaluated outcomes and safety of VRd and KRd. Primary endpoint was progression-free survival (PFS). Of 389 patients with newly diagnosed...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10368661/ https://www.ncbi.nlm.nih.gov/pubmed/37491332 http://dx.doi.org/10.1038/s41408-023-00882-y |
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author | Tan, Carlyn Rose Derkach, Andriy Nemirovsky, David Ciardiello, Amanda Diamond, Benjamin Hultcrantz, Malin Hassoun, Hani Mailankody, Sham Shah, Urvi Maclachlan, Kylee Patel, Dhwani Lahoud, Oscar B. Landau, Heather J. Chung, David J. Shah, Gunjan L. Scordo, Michael Giralt, Sergio A. Lesokhin, Alexander Usmani, Saad Z. Landgren, Ola Korde, Neha |
author_facet | Tan, Carlyn Rose Derkach, Andriy Nemirovsky, David Ciardiello, Amanda Diamond, Benjamin Hultcrantz, Malin Hassoun, Hani Mailankody, Sham Shah, Urvi Maclachlan, Kylee Patel, Dhwani Lahoud, Oscar B. Landau, Heather J. Chung, David J. Shah, Gunjan L. Scordo, Michael Giralt, Sergio A. Lesokhin, Alexander Usmani, Saad Z. Landgren, Ola Korde, Neha |
author_sort | Tan, Carlyn Rose |
collection | PubMed |
description | Lenalidomide and dexamethasone with bortezomib (VRd) or carfilzomib (KRd) are commonly used induction regimens in the U.S. This single-center, retrospective study evaluated outcomes and safety of VRd and KRd. Primary endpoint was progression-free survival (PFS). Of 389 patients with newly diagnosed multiple myeloma, 198 received VRd and 191 received KRd. Median PFS was not reached (NR) in both groups; 5-year PFS was 56% (95%CI, 48–64%) for VRd and 67% (60–75%) for KRd (P = 0.027). Estimated 5-year EFS was 34% (95%CI, 27–42%) for VRd and 52% (45–60%) for KRd (P < 0.001) with corresponding 5-year OS of 80% (95%CI, 75–87%) and 90% (85–95%), respectively (P = 0.053). For standard-risk patients, 5-year PFS was 68% (95%CI, 60–78%) for VRd and 75% (65–85%) for KRd (P = 0.20) with 5-year OS of 87% (95%CI, 81–94%) and 93% (87–99%), respectively (P = 0.13). For high-risk patients, median PFS was 41 months (95%CI, 32.8–61.1) for VRd and 70.9 months (58.2-NR) for KRd (P = 0.016). Respective 5-year PFS and OS were 35% (95%CI, 24–51%) and 69% (58–82%) for VRd and 58% (47–71%) and 88% (80–97%, P = 0.044) for KRd. Overall, KRd resulted in improved PFS and EFS with a trend toward improved OS compared to VRd with associations primarily driven by improvements in outcome for high-risk patients. |
format | Online Article Text |
id | pubmed-10368661 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-103686612023-07-27 Bortezomib, lenalidomide and dexamethasone (VRd) vs carfilzomib, lenalidomide and dexamethasone (KRd) as induction therapy in newly diagnosed multiple myeloma Tan, Carlyn Rose Derkach, Andriy Nemirovsky, David Ciardiello, Amanda Diamond, Benjamin Hultcrantz, Malin Hassoun, Hani Mailankody, Sham Shah, Urvi Maclachlan, Kylee Patel, Dhwani Lahoud, Oscar B. Landau, Heather J. Chung, David J. Shah, Gunjan L. Scordo, Michael Giralt, Sergio A. Lesokhin, Alexander Usmani, Saad Z. Landgren, Ola Korde, Neha Blood Cancer J Article Lenalidomide and dexamethasone with bortezomib (VRd) or carfilzomib (KRd) are commonly used induction regimens in the U.S. This single-center, retrospective study evaluated outcomes and safety of VRd and KRd. Primary endpoint was progression-free survival (PFS). Of 389 patients with newly diagnosed multiple myeloma, 198 received VRd and 191 received KRd. Median PFS was not reached (NR) in both groups; 5-year PFS was 56% (95%CI, 48–64%) for VRd and 67% (60–75%) for KRd (P = 0.027). Estimated 5-year EFS was 34% (95%CI, 27–42%) for VRd and 52% (45–60%) for KRd (P < 0.001) with corresponding 5-year OS of 80% (95%CI, 75–87%) and 90% (85–95%), respectively (P = 0.053). For standard-risk patients, 5-year PFS was 68% (95%CI, 60–78%) for VRd and 75% (65–85%) for KRd (P = 0.20) with 5-year OS of 87% (95%CI, 81–94%) and 93% (87–99%), respectively (P = 0.13). For high-risk patients, median PFS was 41 months (95%CI, 32.8–61.1) for VRd and 70.9 months (58.2-NR) for KRd (P = 0.016). Respective 5-year PFS and OS were 35% (95%CI, 24–51%) and 69% (58–82%) for VRd and 58% (47–71%) and 88% (80–97%, P = 0.044) for KRd. Overall, KRd resulted in improved PFS and EFS with a trend toward improved OS compared to VRd with associations primarily driven by improvements in outcome for high-risk patients. Nature Publishing Group UK 2023-07-25 /pmc/articles/PMC10368661/ /pubmed/37491332 http://dx.doi.org/10.1038/s41408-023-00882-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Tan, Carlyn Rose Derkach, Andriy Nemirovsky, David Ciardiello, Amanda Diamond, Benjamin Hultcrantz, Malin Hassoun, Hani Mailankody, Sham Shah, Urvi Maclachlan, Kylee Patel, Dhwani Lahoud, Oscar B. Landau, Heather J. Chung, David J. Shah, Gunjan L. Scordo, Michael Giralt, Sergio A. Lesokhin, Alexander Usmani, Saad Z. Landgren, Ola Korde, Neha Bortezomib, lenalidomide and dexamethasone (VRd) vs carfilzomib, lenalidomide and dexamethasone (KRd) as induction therapy in newly diagnosed multiple myeloma |
title | Bortezomib, lenalidomide and dexamethasone (VRd) vs carfilzomib, lenalidomide and dexamethasone (KRd) as induction therapy in newly diagnosed multiple myeloma |
title_full | Bortezomib, lenalidomide and dexamethasone (VRd) vs carfilzomib, lenalidomide and dexamethasone (KRd) as induction therapy in newly diagnosed multiple myeloma |
title_fullStr | Bortezomib, lenalidomide and dexamethasone (VRd) vs carfilzomib, lenalidomide and dexamethasone (KRd) as induction therapy in newly diagnosed multiple myeloma |
title_full_unstemmed | Bortezomib, lenalidomide and dexamethasone (VRd) vs carfilzomib, lenalidomide and dexamethasone (KRd) as induction therapy in newly diagnosed multiple myeloma |
title_short | Bortezomib, lenalidomide and dexamethasone (VRd) vs carfilzomib, lenalidomide and dexamethasone (KRd) as induction therapy in newly diagnosed multiple myeloma |
title_sort | bortezomib, lenalidomide and dexamethasone (vrd) vs carfilzomib, lenalidomide and dexamethasone (krd) as induction therapy in newly diagnosed multiple myeloma |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10368661/ https://www.ncbi.nlm.nih.gov/pubmed/37491332 http://dx.doi.org/10.1038/s41408-023-00882-y |
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