Bortezomib plus intermediate-dose dexamethasone and thalidomide in elderly untreated patients with multiple myeloma: a Chinese experience.
Bortezomib has proven to be active in patients with multiple myeloma (MM), including elderly patients. The aim of this study was to evaluate the efficacy and toxicity of bortezomib in combination with intermediate-dose dexamethasone (Dex) and thalidomide in untreated MM patients aged > or =65 years in a Chinese single center. In this study, 18 patients were treated with bortezomib at 1.3 mg/m(2) IV on Days 1, 4, 8, and 11 and Dex at 20 mg/day IV on Days 1-4 and 8-11 simultaneously. Thalidomide at dose of 100 mg/day was given everyday. The mean number of cycles of bortezomib treatment was 2.06. Three patients (17%) achieved a complete response (CR), four (22%) a very good partial response (VGPR), and nine (50%) a PR, resulting in an overall response rate of 89%. The median time to response was 22 days (range 14-50 days). The duration of response was significantly longer in patients achieving a CR/VGPR with respect to those achieving only a PR (8.5 vs. 4.2 months, P = 0.03). Grade 3-4 toxicities occurring in patients comprised weakness, thrombocytopenia, diarrhea, infection, and neuropathy. Only one patient suffered from deep vein thrombosis. This preliminary experience in Chinese patients indicated that bortezomib-Dex-thalidomide is highly effective in elderly untreated patients with MM, even in patients with poor prognostic features.
Guo
Hongfeng
H
Department of Hematology, Wuxi People's Hospital, Nanjing Medical University, 299 Qingyang Road, Wuxi, China.
Zhou
Xin
X
Jiang
Yuanqiang
Y
Yang
Guohua
G
Sun
Chao
C
Zhuang
Yun
Y
Sun
Hongli
H
Lu
Mize
M
Qian
Xifeng
X
Chen
Feng
F
Mao
Jingjue
J
Chen
Heng
H
Xia
Jun
J
Shen
Yunfeng
Y
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001897:Boronic Acids / Q000008:administration & dosage / Q000494:pharmacology / Q000633:toxicity; D000069286:Bortezomib; D002681:China; D003907:Dexamethasone / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy*; D011719:Pyrazines / Q000008:administration & dosage / Q000494:pharmacology / Q000633:toxicity; D012074:Remission Induction; D013792:Thalidomide / Q000008:administration & dosage; D016896:Treatment Outcome
D001897:Boronic Acids; D011719:Pyrazines; D013792:Thalidomide; D000069286:Bortezomib; D003907:Dexamethasone