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Cyclophosphamide, bortezomib and dexamethasone (CyBorD) induction for newly diagnosed multiple myeloma: High response rates in a phase II clinical trial

We have studied a three drug combination with bortezomib, cyclophosphamide and dexamethasone (CyBorD) on a 28 day cycle in the treatment of newly diagnosed multiple myeloma patients to assess response and toxicity. The primary endpoint of response was evaluated after four cycles. Thirty-three newly...

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Detalles Bibliográficos
Autores principales: Reeder, Craig B., Reece, Donna E., Kukreti, Vishal, Chen, Christine, Trudel, Suzanne, Hentz, Joseph, Noble, Brie, Pirooz, Nicholas A., Spong, Jacy E., Piza, Jesus G., Zepeda, Victor H. Jimenez, Mikhael, Joseph R., Leis, Jose F., Bergsagel, P. Leif, Fonseca, Rafael, Stewart, A. Keith
Formato: Texto
Lenguaje:English
Publicado: 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2711213/
https://www.ncbi.nlm.nih.gov/pubmed/19225538
http://dx.doi.org/10.1038/leu.2009.26
Descripción
Sumario:We have studied a three drug combination with bortezomib, cyclophosphamide and dexamethasone (CyBorD) on a 28 day cycle in the treatment of newly diagnosed multiple myeloma patients to assess response and toxicity. The primary endpoint of response was evaluated after four cycles. Thirty-three newly diagnosed, symptomatic patients with multiple myeloma received bortezomib 1.3 mg/m(2) intravenously on days 1, 4, 8, 11, cyclophosphamide 300 mg/m(2) orally days 1, 8, 15, 22 and dexamethasone 40 mg orally days 1-4, 9-12, 17-20 on a 28 day cycle for four cycles. Responses were rapid with a mean 80% decline in the sentinel monoclonal protein at the end of two cycles. The overall intent to treat response rate (≥ partial response) was 88% with 61% ≥VGPR and 39% CR/nCR. For the 28 patients that completed all 4 cycles of therapy the CR/nCR rate was 46% and ≥VGPR rate 71%. All patients undergoing stem cell harvest had a successful collection. Twenty three patients underwent SCT and are evaluable through day 100 with CR/nCR documented in 70% and ≥VGPR in 74%. In conclusion, CyBorD produces a rapid and profound response in patients with newly diagnosed multiple myeloma with manageable toxicity.