title: Impact of prior therapies on the relative efficacy of bortezomib compared with dexamethasone in patients with relapsed/refractory multiple myeloma.
abstract: This subgroup analysis of the phase III APEX (Assessment of Proteasome Inhibition for Extending Remissions) trial examined whether prior exposure to specific therapies affected the relative efficacy of bortezomib versus dexamethasone in relapsed/refractory myeloma. Time to progression and overall survival were superior with bortezomib in all subgroups, with no evidence of interaction between any prior therapies and assignment to study therapy. Patients with prior thalidomide exposure had worse outcomes overall, but neither prior thalidomide nor prior autologous stem cell transplantation affected the relative efficacy of bortezomib versus dexamethasone. These results confirm the superiority of bortezomib over dexamethasone, regardless of prior exposure to specific therapies (clinicaltrials.gov: NCT00048230).
authors.affiliation: Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA 19104, USA. Dan.Vogl@uphs.upenn.edu
authors.forename: Dan T
authors.initials: DT
authors.lastname: Vogl
authors.forename: Edward A
authors.initials: EA
authors.lastname: Stadtmauer
authors.forename: Paul G
authors.initials: PG
authors.lastname: Richardson
authors.forename: Pieter
authors.initials: P
authors.lastname: Sonneveld
authors.forename: Michael W
authors.initials: MW
authors.lastname: Schuster
authors.forename: David
authors.initials: D
authors.lastname: Irwin
authors.forename: Thierry
authors.initials: T
authors.lastname: Facon
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Harousseau
authors.forename: Anthony
authors.initials: A
authors.lastname: Boral
authors.forename: Rachel
authors.initials: R
authors.lastname: Neuwirth
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Anderson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001897:Boronic Acids / Q000627:therapeutic use*; D000069286:Bortezomib; D003907:Dexamethasone / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D011719:Pyrazines / Q000627:therapeutic use*; D012008:Recurrence; D033581:Stem Cell Transplantation; D016019:Survival Analysis; D013792:Thalidomide / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D013792:Thalidomide; D000069286:Bortezomib; D003907:Dexamethasone