Efficacy and safety of bortezomib, thalidomide, and lenalidomide in multiple myeloma: An overview of systematic reviews with meta-analyses

Aguiar, Patrícia Melo; Lima, Tácio de Mendonça; Colleoni, Gisele W. B.; Storpirtis, Sílvia

doi:10.1016/j.critrevonc.2017.03.014

Cited by 36 publications

(26 citation statements)

References 48 publications

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“…However, we did not find any association between IMiD treatment and a VTE higher risk, and surprisingly, the difference between the two patient groups was no longer evident beyond the first two treatment cycles. Moreover, our results suggest that the thromboembolic risk related to IMiDs might also be over‐evaluated . A protective effect of bortezomib against VTE, when added to an IMiDs, has also been reported in some studies .…”

Section: Discussionsupporting

confidence: 81%

See 1 more Smart Citation

Thrombin generation in newly diagnosed multiple myeloma during the first three cycles of treatment: An observational cohort study

Chalayer

Tardy‐Poncet

Karlin

et al. 2019

Research and Practice in Thrombosis and Haemostasis

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BackgroundMultiple myeloma (MM) is associated with a high risk of thrombosis, particularly during the first months of treatment including immunomodulatory drugs (IMiDs). There is no consensus on prevention of thromboembolic risk in patients with de novo MM, and identification of patients requiring anticoagulant thromboprophylaxis remains challenging. Evaluating coagulability by an in vitro thrombin generation (TG) test might be a way of identifying such patients.ObjectiveTo determine whether TG assessment could reveal an increase in coagulability during the first three chemotherapy cycles.MethodsThis prospective and longitudinal observational study included patients newly diagnosed with MM. TG was determined in platelet‐rich and platelet‐poor plasma using calibrated automated thrombography with a low tissue factor (TF) concentration.ResultsSeventy‐one patients were enrolled, allowing TG analysis during 213 chemotherapy cycles. TG remained unchanged throughout follow‐up irrespective of treatment regimen, but values determined before cycles 2 and 3 were significantly higher in patients receiving iMiDs‐containing regimens. No association was found between TG and its changes and thrombosis occurrence during follow‐up: venous thrombosis in eight patients; no cardiovascular event. A significantly (87%) lower risk of venous thrombosis was observed in patients receiving prophylaxis with a low‐molecular‐weight heparin (LMWH; OR: 0.13 (95% CI: 0.02‐0.76). Neither bortezomib‐ nor dexamethasone‐containing regimens were associated with thrombotic risk. Changes in TG, as studied, were not associated with thrombotic events.ConclusionsThe only factor associated with a reduction in early thrombotic risk was prophylaxis with LMWH. The issue of how to identify patients requiring prophylactic anticoagulation remains unresolved.

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Section: Discussionsupporting

confidence: 81%

“…Moreover, our results suggest that the thromboembolic risk related to IMiDs might also be over-evaluated. 20 A protective effect of bortezomib against VTE, when added to an IMiDs, has also been reported in some studies. 21 Our data do not confirm these findings, in agreement with the results of a meta-analysis.…”

Section: Resultsmentioning

confidence: 79%

Thrombin generation in newly diagnosed multiple myeloma during the first three cycles of treatment: An observational cohort study

Chalayer

Tardy‐Poncet

Karlin

et al. 2019

Research and Practice in Thrombosis and Haemostasis

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“…The incidence of thalidomide-related neuropathy (all grades) varies between 10% and 83%. [21][22][23][35][36][37] With TVD combination, the risk of peripheral neuropathy ≥grade 3 is about 10 to 31%, [26][27][28][29]38 in comparison with our 5% rate with RVD combination. This rate of peripheral neuropathy ≥grade 3 related to RVD was similar to the rate found by Rosiñol et al comparing RVD and TVD (5% versus 15.4%).…”

Section: Discussioncontrasting

confidence: 47%

“…20 Moreover, a lower risk of drug-related serious neuropathy has been reported with the association of lenalidomide with bortezomib compared to the association of thalidomide and bortezomib. [21][22][23] Nevertheless, this regimen has never been reported in real-life practice. So, we led a retrospective study evaluating a transplantation-based approach with RVD combination as induction and consolidation and lenalidomide maintenance outside clinical trials, with patients from the real life.…”

mentioning

confidence: 99%

Efficacy and safety of autologous stem cell transplantation after induction therapy with lenalidomide, bortezomib, and dexamethasone

Arcani

Venton

Colle

et al. 2019

European J of Haematology

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Objectives Recently, phase III trials assessed a new combination of lenalidomide, bortezomib, and dexamethasone (RVD) in induction therapy in transplantation‐eligible multiple myeloma (MM) patients, before consolidation with RVD and lenalidomide maintenance. We present a retrospective study evaluating this approach with patients from the real life. Methods We conducted a retrospective single‐arm study to assess efficacy and safety of RVD combination in induction therapy before high‐dose chemotherapy with melphalan followed by autologous stem cell transplantation, and RVD consolidation followed by lenalidomide maintenance, from February 2011 to May 2016. Results Forty patients were enrolled. The mean age at diagnosis was 56 years. Median progression‐free survival was 45 months, and median overall survival was 76 months. The only factor found associated with better PFS was a negative minimal residual disease (P < .01). Twenty‐six (65%) patients experimented adverse events: 8 patients (20%) underwent 12 serious AE (≥grade 3). Treatment discontinuation occurred in 2 patients (5%) because of severe AE. Conclusion To our knowledge, this work provides the first evidence of the efficacy and the safety of RVD combination in patients treated in common practice.

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“…A significantly shorter time to neuropathy onset of no longer than 12 weeks from baseline was disclosed in another study enrolling 31 thalidomide‐treated patients (200 mg/day, total dose: 21 g) with newly diagnosed multiple myeloma before and after 4 months of therapy . Lenalidomide, given at a dose of 30 mg orally or 15 mg twice daily (days 1‐21 every 28 days) appears much less neurotoxic with essentially no grade 3 or 4 events in comparison with placebo or other drugs, especially thalidomide . In any case, there are no published data to allow estimating the time to neuropathy onset after commencing lenalidomide.…”

Section: Time Course Of Neuropathy Onset and Unique Temporal Featuresmentioning

confidence: 99%

Vinca alkaloids, thalidomide and eribulin‐induced peripheral neurotoxicity: From pathogenesis to treatment

Islam

Lustberg

Staff

et al. 2019

J Peripheral Nervous Sys

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Vinca alkaloids, thalidomide, and eribulin are widely used to treat patients with childhood acute lymphoblastic leukemia (ALL), adults affected by multiple myeloma and locally invasive or metastatic breast cancer, respectively. However, soon after their introduction into clinical practice, chemotherapy-induced peripheral neurotoxicity (CIPN) emerged as their main non-hematological and among dose-limiting adverse events. It is generally perceived that vinca alkaloids and the antiangiogenic agent thalidomide are more neurotoxic, compared to eribulin. The exposure to these chemotherapeutic agents is associated with an axonal, length-dependent, sensory polyneuropathy of mild to moderate severity, whereas it is considered that the peripheral nerve damage, unless severe, usually resolves soon after treatment discontinuation. Advanced age, high initial and prolonged dosing, coadministration of other neurotoxic chemotherapeutic agents and pre-existing neuropathy are the common risk factors. Pharmacogenetic biomarkers might be used to define patients at increased susceptibility of CIPN. Currently, there is no established therapy for CIPN prevention or treatment; symptomatic treatment for neuropathic pain and dose reduction or withdrawal in severe cases is considered, at the cost of reduced cancer therapeutic efficacy. This review critically examines the pathogenesis, epidemiology, risk factors (both clinical and pharmacogenetic), clinical phenotype and management of CIPN as a result of exposure to vinca alkaloids, thalidomide and its analogue lenalidomide as also eribulin. K E Y W O R D S assessment, eribulin, peripheral neurotoxicity, thalidomide, vinca alkaloids

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Efficacy and safety of bortezomib, thalidomide, and lenalidomide in multiple myeloma: An overview of systematic reviews with meta-analyses

Cited by 36 publications

References 48 publications

Thrombin generation in newly diagnosed multiple myeloma during the first three cycles of treatment: An observational cohort study

Thrombin generation in newly diagnosed multiple myeloma during the first three cycles of treatment: An observational cohort study

Efficacy and safety of autologous stem cell transplantation after induction therapy with lenalidomide, bortezomib, and dexamethasone

Vinca alkaloids, thalidomide and eribulin‐induced peripheral neurotoxicity: From pathogenesis to treatment

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