title: Bortezomib plus dexamethasone versus reduced-dose bortezomib, thalidomide plus dexamethasone as induction treatment before autologous stem cell transplantation in newly diagnosed multiple myeloma.
abstract: The Intergroupe Francophone du Myelome conducted a randomized trial to compare bortezomib-dexamethasone (VD) as induction before high-dose therapy (HDT) and autologous stem cell transplantation (ASCT) to a combination consisting of reduced doses of bortezomib and thalidomide plus dexamethasone (vtD) in patients with multiple myeloma. Overall, a total of 199 patients were centrally randomly assigned to receive VD or vtD. After 4 cycles, the complete response (CR) rate was the same in both groups (13% in the vtD arm, 12% in the VD arm, P = .74). However, the CR plus very good partial response (VGPR) rate was significantly higher in the vtD arm (49% vs 36%, P = .05). After ASCT, the CR plus VGPR rate was significantly higher in the vtD arm (74% vs 58%, P = .02). The reduced doses of bortezomib and thalidomide translated into a reduced incidence of peripheral neuropathy (PN): grade ≥ 2 PN were reported in 34% in the VD arm versus 14% in the vtD arm (P = .001). vtD, including reduced doses of bortezomib and thalidomide, yields higher VGPR rates compared with VD and can be considered a new effective triplet combination before HDT/ASCT.
authors.affiliation: University Hospital, Nantes, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Moreau
authors.forename: Herve
authors.initials: H
authors.lastname: Avet-Loiseau
authors.forename: Thierry
authors.initials: T
authors.lastname: Facon
authors.forename: Michel
authors.initials: M
authors.lastname: Attal
authors.forename: Mourad
authors.initials: M
authors.lastname: Tiab
authors.forename: Cyrille
authors.initials: C
authors.lastname: Hulin
authors.forename: Chantal
authors.initials: C
authors.lastname: Doyen
authors.forename: Laurent
authors.initials: L
authors.lastname: Garderet
authors.forename: Edouard
authors.initials: E
authors.lastname: Randriamalala
authors.forename: Carla
authors.initials: C
authors.lastname: Araujo
authors.forename: Gérard
authors.initials: G
authors.lastname: Lepeu
authors.forename: Gerald
authors.initials: G
authors.lastname: Marit
authors.forename: Denis
authors.initials: D
authors.lastname: Caillot
authors.forename: Martine
authors.initials: M
authors.lastname: Escoffre
authors.forename: Bruno
authors.initials: B
authors.lastname: Lioure
authors.forename: Lotfi
authors.initials: L
authors.lastname: Benboubker
authors.forename: Brigitte
authors.initials: B
authors.lastname: Pégourié
authors.forename: Brigitte
authors.initials: B
authors.lastname: Kolb
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Stoppa
authors.forename: Jean-Gabriel
authors.initials: JG
authors.lastname: Fuzibet
authors.forename: Olivier
authors.initials: O
authors.lastname: Decaux
authors.forename: Mamoun
authors.initials: M
authors.lastname: Dib
authors.forename: Christian
authors.initials: C
authors.lastname: Berthou
authors.forename: Carine
authors.initials: C
authors.lastname: Chaleteix
authors.forename: Catherine
authors.initials: C
authors.lastname: Sebban
authors.forename: Catherine
authors.initials: C
authors.lastname: Traullé
authors.forename: Jean
authors.initials: J
authors.lastname: Fontan
authors.forename: Marc
authors.initials: M
authors.lastname: Wetterwald
authors.forename: Pascal
authors.initials: P
authors.lastname: Lenain
authors.forename: Claire
authors.initials: C
authors.lastname: Mathiot
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Harousseau
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D001897:Boronic Acids / Q000008:administration & dosage* / Q000009:adverse effects; D000069286:Bortezomib; D003131:Combined Modality Therapy; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D011719:Pyrazines / Q000008:administration & dosage* / Q000009:adverse effects; D033581:Stem Cell Transplantation / Q000379:methods; D016019:Survival Analysis; D013792:Thalidomide / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D001897:Boronic Acids; D011719:Pyrazines; D013792:Thalidomide; D000069286:Bortezomib; D003907:Dexamethasone