Τίτλος:
Primary failure of bortezomib in newly diagnosed multiple myeloma-understanding the magnitude, predictors, and significance
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Botezomib-based induction is highly effective for the treatment of newly diagnosed multiple myeloma (NDMM). We investigated the outcomes of NDMM patients who failed to respond to bortezomib-based induction in a real-life clinical setting. In a cohort of 295 consecutive NDMM patients in 3 medical centers, 74 (25%) failed to achieve at least partial response after 4 induction cycles, and were classified as non-responsive. Compared to induction responders, they were older, more frequently anemic, had a higher incidence of del17p and ISS-3, and a worse performance status. In multivariable analysis, bortezomib-based induction failure occurred in 25% of patients and was the strongest independent factor predicting mortality with a 5-fold hazard ratio (95% CI 1.44-8.68). Three-year overall survival in responsive vs. non-responsive patients were 76% vs. 53%, respectively (p < 0.0001). Survival from time of salvage second-line treatment was significantly shorter among induction non-responders vs. responders (25 months vs. not-reached, p = 0.024). © 2015 Taylor & Francis.
Συγγραφείς:
Cohen, Y.C.
Joffe, E.
Benyamini, N.
Dimopoulos, M.A.
Terpos, E.
Trestman, S.
Held-Kuznetsov, V.
Avivi, I.
Kastritis, E.
Περιοδικό:
Clinical Lymphoma Myeloma and Leukemia
Εκδότης:
Taylor and Francis Ltd.
Λέξεις-κλειδιά:
bortezomib; cyclophosphamide; dexamethasone; antineoplastic agent; bortezomib; paraprotein, adult; aged; Article; autologous stem cell transplantation; cancer combination chemotherapy; cancer mortality; cancer patient; cancer prognosis; controlled study; corticosteroid therapy; drug response; drug treatment failure; female; follow up; human; induction chemotherapy; major clinical study; male; medical record review; multiple myeloma; newly diagnosed multiple myeloma; newly diagnosed multiple myeloma; overall survival; priority journal; retrospective study; salvage therapy; cancer staging; drug resistance; hematopoietic stem cell transplantation; middle aged; mortality; multimodality cancer therapy; multiple myeloma; prognosis; proportional hazards model; remission; treatment failure; treatment outcome; tumor recurrence; very elderly, Aged; Aged, 80 and over; Antineoplastic Agents; Bortezomib; Combined Modality Therapy; Drug Resistance, Neoplasm; Female; Hematopoietic Stem Cell Transplantation; Humans; Male; Middle Aged; Multiple Myeloma; Neoplasm Recurrence, Local; Neoplasm Staging; Paraproteins; Prognosis; Proportional Hazards Models; Remission Induction; Treatment Failure; Treatment Outcome
DOI:
10.3109/10428194.2015.1121258
