Oral melphalan, prednisone and thalidomide for newly diagnosed myeloma patients

Palumbo, Antônio; Bertola, Alessandra; Musto, P.; Nunzi, Martina; Stefano, V. De; Catalano, Lucio; Caravita, Tommaso; Cangialosi, Clotilde; Bringen, Sara; Boccadoro, Mario

doi:10.1200/jco.2004.22.90140.6549

Cited by 22 publications

(39 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Indeed, the survival rate with VMP at 3 years is the highest reported to date with MP-based regimens. [5][6][7][8][9][10] These data indicate that, while until recently more than half of patients receiving MP therapy would have died by this time point, with VMP the majority (85%) of patients will be alive at 3 years. This is particularly notable considering the advanced age of the patients in this study (half were aged ≥75 years).…”

Section: Discussionmentioning

confidence: 97%

“…4 The combination demonstrated substantial activity, with a response rate of 89%, including 32% complete responses and 11% near complete responses, 4 the highest complete/near complete response rate reported with MP-based regimens to date. [5][6][7][8][9][10] In addition, responses to VMP were not influenced by cytogenetic abnormalities. The response rate was higher than that among MP-treated historical controls, and 16-month progression-free survival, event-free survival, and overall survival rates were significantly greater with VMP than with MP.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Bortezomib plus melphalan and prednisone in elderly untreated patients with multiple myeloma: updated time-to-events results and prognostic factors for time to progression

Mateos¹,

Hernández²,

Hernández³

et al. 2008

Haematologica

View full text Add to dashboard Cite

BackgroundNew treatment options offering enhanced activity in elderly, newly diagnosed patients with multiple myeloma are required. One strategy is to combine melphalan and prednisone with novel agents. We previously reported an 89% response rate, including 32% complete responses and 11% near complete responses, in our phase 1/2 study of bortezomib plus melphalan and prednisone (VMP) in 60 newly diagnosed multiple myeloma patients with a median age of 75 years. Here, we report updated time-to-events data and the impact of poor prognosis factors on outcome.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Bortezomib plus melphalan and prednisone in elderly untreated patients with multiple myeloma: updated time-to-events results and prognostic factors for time to progression

Mateos¹,

Hernández²,

Hernández³

et al. 2008

Haematologica

View full text Add to dashboard Cite

show abstract

“…29 This regimen did induce an overall response rate, defined as those patients who achieved at least a partial response, of 73%, including the 24% of patients who attained either a complete response (CR) or near-CR. Responses were seen rapidly, with more than 50% of patients reaching a PR within the first 2 months of therapy, and a median time to maximum response of 4 months, thus overcoming one of the disadvantages of MP with its relatively slow onset of action.…”

Section: Mp + Thalidomidementioning

confidence: 99%

Initial Therapy of Multiple Myeloma Patients Who Are Not Candidates for Stem Cell Transplantation

Orłowski¹

2006

Hematology

View full text Add to dashboard Cite

Multiple myeloma patients deemed to not be candidates for high-dose therapy followed by stem cell rescue who nonetheless need chemotherapy have traditionally received an oral regimen combining melphalan and prednisone. With the advent of novel agents, however, such as immunomodulatory drugs and proteasome inhibitors that are active in the relapsed/refractory setting, there has been an impetus to incorporate these new options into front-line therapy. Several phase II studies have recently revealed that addition of either thalidomide, lenalidomide, or bortezomib to melphalan and prednisone increased the overall and complete response rates, albeit at the cost of some increased toxicity. Randomized phase III studies of melphalan and prednisone with thalidomide have already shown that, compared to melphalan and prednisone alone, the three-drug regimen prolonged time to progression and overall survival in this population, thereby defining a new standard of care. Moreover, our increasing knowledge of the molecular role that cytogenetic abnormalities play in the biology of multiple myeloma and our growing chemotherapeutic armamentarium are beginning to allow us to rationally select therapies based on these characteristics of each patient's disease. Such a risk-and molecular-adapted strategy to the therapy of multiple myeloma promises to revolutionize and personalize our care of these patients and bring us closer to a cure for this disease.Using the diagnostic criteria recommended by the International Working Group, patients with multiple myeloma are classified as having either asymptomatic or symptomatic (Table 1) disease. 1 The latter population, generally considered candidates for a chemotherapy-based intervention, are then further divided into those who either are or are not eligible for high-dose chemotherapy followed by stem cell rescue. 2 Criteria that are weighed to help make this second distinction have generally included age, performance status, and co-morbid medical conditions. 2 There is some variability in these parameters and how they are applied, since studies examining stem cell transplantation have used different criteria. In regard to age, for example, which is the most objective of these measures, initial studies tended to enroll patients younger than 65 years of age, 3 while more recent studies suggest that transplant is safe in at least some who are over the age of 70 (for example 4,5 ). On the other hand, data suggesting that patients with poor-risk chromosomal features have a short time to progression after autologous transplantation have led to suggestions that even younger patients with these abnormalities may not be candidates for standard approaches. Nonetheless, as little as two years ago, there was general agreement that the standard of care for patients who were not eligible for transplantation and yet needed chemotherapy was melphalan

show abstract

“…melphalan arm, and not reached at 56 months for the MPT arm (74). In the same way that thalidomide and dexamethasone in combination produce DVT, the same phenomena has been observed in the application of MPT (70,75,76). These compelling data from the Intergroup Francophone du Myelome 99-06 study have led us to adopt MPT at the Mayo Clinic as the preferred treatment of newly diagnosed patients with MM who are not candidates for transplant.…”

Section: Melphalan and Prednisone With Thalidomide And Revlimidmentioning

confidence: 88%

Targeted therapeutics for multiple myeloma: The arrival of a risk-stratified approach

Fonseca

Stewart

2007

Molecular Cancer Therapeutics

View full text Add to dashboard Cite

show abstract

Oral melphalan, prednisone and thalidomide for newly diagnosed myeloma patients

Cited by 22 publications

References 4 publications

Bortezomib plus melphalan and prednisone in elderly untreated patients with multiple myeloma: updated time-to-events results and prognostic factors for time to progression

Bortezomib plus melphalan and prednisone in elderly untreated patients with multiple myeloma: updated time-to-events results and prognostic factors for time to progression

Initial Therapy of Multiple Myeloma Patients Who Are Not Candidates for Stem Cell Transplantation

Targeted therapeutics for multiple myeloma: The arrival of a risk-stratified approach

Contact Info

Product

Resources

About