Pf594 Bortezomib-Lenalidomide-Dexamethasone vs Bortezomib-Thalidomide-Dexamethasone Induction: Integrated Analysis of Randomized Controlled Trials in Transplant-Eligible Newly Diagnosed Multiple Myeloma

Rosiñol, Laura; Hébraud, Benjamin; Oriol, Albert; Colin, Angélique; Hulin, Cyrille; Blanchard, María Jesús; Caillot, Denis; Sureda, A; Hernandez, Miguel-T; Arnulf, Bertrand; Mateos, M.V.; Macro, M.; Miguel, Jesús San; Belhadj, Karim; Lahuerta, Juan José; Garelik, M. Brigid; Bladé, J; Moreau, Philippe; Attal, Michel

doi:10.1097/01.hs9.0000560664.00507.c9

Cited by 5 publications

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results show that 66.01% (202/306) of NDMM patients reported infections within the first 4 months from the initiation of treatment, and 40.20% (123/306) ≥ 3 TE infections. The total number of any grade infections in this study was higher than the results of other series (37.3-61.8%; Rosiñol et al, 2019;Voorhees et al, 2020). It was also higher when compared with grade ≥ 3 infection in prior trials (11.9-20.37%; Dumontet et al, 2018;Encinas et al, 2022;Shang et al, 2022).…”

Section: Discussioncontrasting

confidence: 72%

Eastern Cooperative Oncology Group, β2-microglobulin, hemoglobin, and lactate dehydrogenase can predict early grade ≥ 3 infection in patients with newly diagnosed multiple myeloma: A real-world multicenter study

Liu²,

Zhang³

et al. 2023

Front. Microbiol.

View full text Add to dashboard Cite

IntroductionThis research explored the clinical application of grade ≥ 3 infection predictive models for the newly diagnosed multiple myeloma (NDMM) population.MethodsIt evaluated 306 patients with NDMM based on three different predictive models. The relationship between the grade ≥ 3 infection rates in NDMM and the scores was analyzed retrospectively. The cumulative incidence of early grade ≥ 3 infection was estimated using the Kaplan–Meier method and log-rank test to assess the statistical significance of the difference. To compare the predictive performance in the prediction of infection, the Receiver Operating Characteristic Curve (ROC) curve was used to show the area under the curve (AUC), and DeLong’s test was used to analyze the difference in AUC.ResultsThe incidence of grade ≥ 3 infection within the first 4 months of NDMM was 40.20%. Concerning the FIRST score (predictors: ECOG, β2-microglobulin, hemoglobin, and lactate dehydrogenase), GEM-PETHEMA score (predictors: albumin, male sex, ECOG, and non-IgA type MM), and Infection Risk model of Multiple Myeloma (IRMM) score (predictors: ECOG, serum β2-microglobulin, globulin, and hemoglobin), the probability of early grade ≥ 3 infection in the different groups showed statistically significant differences (low-risk vs. high-risk: 25.81% vs. 50.00%, p < 0.001; low-risk vs. moderate-risk vs. high-risk: 35.93% vs. 41.28% vs. 60.00%, p= 0.045; low-risk vs. moderate-risk vs. high-risk: 20.00% vs. 43.75% vs. 52.04%, p < 0.001). Statistical differences existed in the probability of early grade ≥ 3 infection among the different groups by the FIRST and IRMM scores but no statistical differences in the GEM-PETHEMA score (p < 0.001, p< 0.001, and p = 0.090, respectively). The FIRST score showed good discrimination and simple calculation with highest AUC. Further subgroup analysis showed that the FIRST score could still apply for patients treated with bortezomib-based regimen and frail patients.DiscussionOur findings indicate that the FIRST score (consisting of ECOG, β2-microglobulin, hemoglobin, and lactate dehydrogenase) is a simple and robust infection stratification tool for patients with NDMM and could be used in routine clinical work.

show abstract

Section: Discussioncontrasting

confidence: 72%

Eastern Cooperative Oncology Group, β2-microglobulin, hemoglobin, and lactate dehydrogenase can predict early grade ≥ 3 infection in patients with newly diagnosed multiple myeloma: A real-world multicenter study

Liu²,

Zhang³

et al. 2023

Front. Microbiol.

View full text Add to dashboard Cite

show abstract

“…5,26 A cross trial comparison of GEM 2012 and GEM 2005 demonstrated statistically significant improvement in post-induction and post-ASCT ≥VGPR rates with the use of six cycles of RVD compared to six cycles of VTD. 27 Of note, higher rates of Grade 3/4 haematological toxicities were seen with RVD compared with VTD but significantly lower rates of peripheral neuropathy were noted. Despite the limited number of direct comparisons of RVD to other induction strategies in the transplant-eligible population, the totality of evidence reflected by improved response rates and manageable toxicities, as well as clinical benefit, RVD has become a standard of care for induction therapy for most transplant-eligible patients with MM.…”

Section: W H At Is Th E Ev Ide Nce For Th E Tr a Nspl A N T-e Ligibl ...mentioning

confidence: 89%

Lenalidomide, bortezomib and dexamethasone induction therapy for the treatment of newly diagnosed multiple myeloma: a practical review

et al. 2022

View full text Add to dashboard Cite

Summary For patients with newly diagnosed multiple myeloma, survival outcomes continue to improve significantly: however, nearly all patients will relapse following induction treatment. Optimisation of induction therapy is essential to provide longer term disease control and the current standard of care for most patients incorporates an immunomodulatory agent and proteasome inhibitor, most commonly lenalidomide and bortezomib in combination with dexamethasone (RVD), with maintenance until progression. Historically there has been limited access to RVD as an induction strategy outside of the United States; fortunately, there is now increasing access worldwide. This review discusses the rationale for use of RVD as induction therapy and aims to provide guidance in prescribing this regimen in order to optimise efficacy while minimising the toxicities of treatment. We also highlight the increasing evidence for the utility of addition of a monoclonal antibody to the RVD backbone to deepen responses and potentially provide longer disease control.

show abstract

“…The bortezomib, thalidomide, and dexamethasone (VTD) regimen has been used in NDMM outside of the USA, 51 with no randomized controlled trials comparing RVd versus VTD conducted to date. Thus, findings from the PETHEMA/GEM2005, PETHEMA/GEM2012, IFM 2009, and IFM 2013-04 trials were used to conduct an integrated analysis 52 evaluating RVd versus VTD in TE NDMM. 43 , 49 , 53 , 54 In the GEM studies, the rate of ≥VGPR after induction was higher with RVd than with VTD (70.1% vs .…”

Section: Rvd: Phase III Studies In Newly Diagnosed Multiple Myelomamentioning

confidence: 99%

Clinical perspectives on the optimal use of lenalidomide plus bortezomib and dexamethasone for the treatment of newly diagnosed multiple myeloma

Richardson,

Durie,

Rosiñol

et al. 2023

haematol

View full text Add to dashboard Cite

To improve patient outcomes in the otherwise incurable hematologic malignancy of multiple myeloma (MM), a key paradigm includes initial treatment to establish disease control rapidly followed by maintenance therapy to ensure durability of response with manageable toxicity. However, patient prognosis becomes worse after relapse, and the disease burden and drug toxicities are generally more challenging with subsequent lines of therapy. It is therefore particularly important that patients with newly diagnosed multiple myeloma (NDMM) receive optimal frontline therapy. The combination of lenalidomide, bortezomib, and dexamethasone (RVd) has consistently demonstrated a tolerable safety profile with significant and clinically relevant benefit, including deep and durable responses with improved survival in patients with NDMM regardless of their transplant eligibility. Furthermore, comparative studies evaluating this triplet against both doublets and other triplet regimens have established RVd as a standard of care in this setting based upon its remarkable and concordant efficacy. Given the breadth of clinical data, physician familiarity, inclusion in treatment guidelines, and the emerging potential of RVd-containing quadruplet regimens, RVd will likely continue as a key cornerstone of NDMM therapy, and its role will therefore likely continue to grow as a therapeutic backbone in the initial treatment of MM.

show abstract

Pf594 Bortezomib-Lenalidomide-Dexamethasone vs Bortezomib-Thalidomide-Dexamethasone Induction: Integrated Analysis of Randomized Controlled Trials in Transplant-Eligible Newly Diagnosed Multiple Myeloma

Cited by 5 publications

References 0 publications

Eastern Cooperative Oncology Group, β2-microglobulin, hemoglobin, and lactate dehydrogenase can predict early grade ≥ 3 infection in patients with newly diagnosed multiple myeloma: A real-world multicenter study

Eastern Cooperative Oncology Group, β2-microglobulin, hemoglobin, and lactate dehydrogenase can predict early grade ≥ 3 infection in patients with newly diagnosed multiple myeloma: A real-world multicenter study

Lenalidomide, bortezomib and dexamethasone induction therapy for the treatment of newly diagnosed multiple myeloma: a practical review

Clinical perspectives on the optimal use of lenalidomide plus bortezomib and dexamethasone for the treatment of newly diagnosed multiple myeloma

Contact Info

Product

Resources

About