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Partial Response at Completion of Bortezomib-Thalidomide-Dexamethasone (VTd) Induction Regimen Upfront in Multiple Myeloma Does Not Preclude Response to VTd in Consolidation
The impact of consolidation on response rates and PFS has recently been demonstrated after induction and autotransplantation upfront in Multiple Myeloma (MM). We further showed that patients in ≥VGPR following the intensification procedure benefited most from consolidation. Question remains as to th...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Ivyspring International Publisher
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3963082/ https://www.ncbi.nlm.nih.gov/pubmed/24665349 http://dx.doi.org/10.7150/jca.8541 |
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author | Fouquet, Guillemette Hebraud, Benjamin Garciaz, Sylvain Stoppa, Anne Marie Roussel, Murielle Caillot, Denis Chrétien, Marie Lorraine Arnulf, Bertrand Szalat, Raphael Garderet, Laurent Benajiba, Lina Pegourie, Brigitte Regny, Caroline Royer, Bruno Caulier, Alexis Touzeau, Cyrille Tessoulin, Benoit Fermand, Jean Paul Facon, Thierry Attal, Michel Loiseau, Hervé Avet Moreau, Philippe Leleu, Xavier |
author_facet | Fouquet, Guillemette Hebraud, Benjamin Garciaz, Sylvain Stoppa, Anne Marie Roussel, Murielle Caillot, Denis Chrétien, Marie Lorraine Arnulf, Bertrand Szalat, Raphael Garderet, Laurent Benajiba, Lina Pegourie, Brigitte Regny, Caroline Royer, Bruno Caulier, Alexis Touzeau, Cyrille Tessoulin, Benoit Fermand, Jean Paul Facon, Thierry Attal, Michel Loiseau, Hervé Avet Moreau, Philippe Leleu, Xavier |
author_sort | Fouquet, Guillemette |
collection | PubMed |
description | The impact of consolidation on response rates and PFS has recently been demonstrated after induction and autotransplantation upfront in Multiple Myeloma (MM). We further showed that patients in ≥VGPR following the intensification procedure benefited most from consolidation. Question remains as to the benefit of consolidation for patients in PR at completion of induction - feature of partial resistance to the induction regimen. We collected data from 54 newly diagnosed MM treated with VTd-auto-VTd regimen that reached only PR at completion of the induction procedure. Overall, 37 patients (68%) improved depth of response (≥VGPR) at completion of consolidation, including 35% that reached CR and 38% solely related to consolidation. Of patients that remained on PR or improved depth of response after ASCT, 26% and 38% further responded to consolidation, respectively. With a median follow-up of 36 months, improved depth of response translated into lower relapse rate compared with patients remaining in PR, 19% vs. 36%. This difference was more striking in patients that reached CR vs. others, 8% and 38%, respectively (p=0.039). The median TTP was prolonged in patients that improved depth of response after consolidation (p=0.012), with a 3-year TTP of 87% vs. 18% otherwise. In multivariate analysis, lack of improved depth of response to consolidation independently predicted shorten median TTP [OR=4.4, 95%CI=1-21; p=0.039], with elevated LDH and beta2m, and adverse FISH. This study shows that VTd consolidation should be recommended to patients solely on PR at completion of induction with VTd, feature of lower sensitivity to VTd. |
format | Online Article Text |
id | pubmed-3963082 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Ivyspring International Publisher |
record_format | MEDLINE/PubMed |
spelling | pubmed-39630822014-03-24 Partial Response at Completion of Bortezomib-Thalidomide-Dexamethasone (VTd) Induction Regimen Upfront in Multiple Myeloma Does Not Preclude Response to VTd in Consolidation Fouquet, Guillemette Hebraud, Benjamin Garciaz, Sylvain Stoppa, Anne Marie Roussel, Murielle Caillot, Denis Chrétien, Marie Lorraine Arnulf, Bertrand Szalat, Raphael Garderet, Laurent Benajiba, Lina Pegourie, Brigitte Regny, Caroline Royer, Bruno Caulier, Alexis Touzeau, Cyrille Tessoulin, Benoit Fermand, Jean Paul Facon, Thierry Attal, Michel Loiseau, Hervé Avet Moreau, Philippe Leleu, Xavier J Cancer Research Paper The impact of consolidation on response rates and PFS has recently been demonstrated after induction and autotransplantation upfront in Multiple Myeloma (MM). We further showed that patients in ≥VGPR following the intensification procedure benefited most from consolidation. Question remains as to the benefit of consolidation for patients in PR at completion of induction - feature of partial resistance to the induction regimen. We collected data from 54 newly diagnosed MM treated with VTd-auto-VTd regimen that reached only PR at completion of the induction procedure. Overall, 37 patients (68%) improved depth of response (≥VGPR) at completion of consolidation, including 35% that reached CR and 38% solely related to consolidation. Of patients that remained on PR or improved depth of response after ASCT, 26% and 38% further responded to consolidation, respectively. With a median follow-up of 36 months, improved depth of response translated into lower relapse rate compared with patients remaining in PR, 19% vs. 36%. This difference was more striking in patients that reached CR vs. others, 8% and 38%, respectively (p=0.039). The median TTP was prolonged in patients that improved depth of response after consolidation (p=0.012), with a 3-year TTP of 87% vs. 18% otherwise. In multivariate analysis, lack of improved depth of response to consolidation independently predicted shorten median TTP [OR=4.4, 95%CI=1-21; p=0.039], with elevated LDH and beta2m, and adverse FISH. This study shows that VTd consolidation should be recommended to patients solely on PR at completion of induction with VTd, feature of lower sensitivity to VTd. Ivyspring International Publisher 2014-03-11 /pmc/articles/PMC3963082/ /pubmed/24665349 http://dx.doi.org/10.7150/jca.8541 Text en © Ivyspring International Publisher. This is an open-access article distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by-nc-nd/3.0/). Reproduction is permitted for personal, noncommercial use, provided that the article is in whole, unmodified, and properly cited. |
spellingShingle | Research Paper Fouquet, Guillemette Hebraud, Benjamin Garciaz, Sylvain Stoppa, Anne Marie Roussel, Murielle Caillot, Denis Chrétien, Marie Lorraine Arnulf, Bertrand Szalat, Raphael Garderet, Laurent Benajiba, Lina Pegourie, Brigitte Regny, Caroline Royer, Bruno Caulier, Alexis Touzeau, Cyrille Tessoulin, Benoit Fermand, Jean Paul Facon, Thierry Attal, Michel Loiseau, Hervé Avet Moreau, Philippe Leleu, Xavier Partial Response at Completion of Bortezomib-Thalidomide-Dexamethasone (VTd) Induction Regimen Upfront in Multiple Myeloma Does Not Preclude Response to VTd in Consolidation |
title | Partial Response at Completion of Bortezomib-Thalidomide-Dexamethasone (VTd) Induction Regimen Upfront in Multiple Myeloma Does Not Preclude Response to VTd in Consolidation |
title_full | Partial Response at Completion of Bortezomib-Thalidomide-Dexamethasone (VTd) Induction Regimen Upfront in Multiple Myeloma Does Not Preclude Response to VTd in Consolidation |
title_fullStr | Partial Response at Completion of Bortezomib-Thalidomide-Dexamethasone (VTd) Induction Regimen Upfront in Multiple Myeloma Does Not Preclude Response to VTd in Consolidation |
title_full_unstemmed | Partial Response at Completion of Bortezomib-Thalidomide-Dexamethasone (VTd) Induction Regimen Upfront in Multiple Myeloma Does Not Preclude Response to VTd in Consolidation |
title_short | Partial Response at Completion of Bortezomib-Thalidomide-Dexamethasone (VTd) Induction Regimen Upfront in Multiple Myeloma Does Not Preclude Response to VTd in Consolidation |
title_sort | partial response at completion of bortezomib-thalidomide-dexamethasone (vtd) induction regimen upfront in multiple myeloma does not preclude response to vtd in consolidation |
topic | Research Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3963082/ https://www.ncbi.nlm.nih.gov/pubmed/24665349 http://dx.doi.org/10.7150/jca.8541 |
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