PMID- 20048187
OWN - NLM
STAT- MEDLINE
DCOM- 20100304
LR  - 20201215
IS  - 1527-7755 (Electronic)
IS  - 0732-183X (Linking)
VI  - 28
IP  - 5
DP  - 2010 Feb 10
TI  - Bortezomib as induction before autologous transplantation, followed by 
      lenalidomide as consolidation-maintenance in untreated multiple myeloma patients.
PG  - 800-7
LID - 10.1200/JCO.2009.22.7561 [doi]
AB  - PURPOSE To evaluate the effect of bortezomib as induction therapy before 
      autologous transplantation, followed by lenalidomide as consolidation-maintenance 
      in myeloma patients. PATIENTS AND METHODS Newly diagnosed patients age 65 to 75 
      years were eligible. Induction (bortezomib, doxorubicin, and dexamethasone [PAD]) 
      included four 21-day cycles of bortezomib (1.3 mg/m(2) on days 1, 4, 8, and 11), 
      pegylated liposomal doxorubicin (30 mg/m(2) on day 4), and dexamethasone (40 
      mg/d; cycle 1: days 1 to 4, 8 to 11, and 15 to 18; cycles 2 to 4: days 1 to 4). 
      Autologous transplantation was tandem melphalan 100 mg/m(2) (MEL100) and 
      stem-cell support. Consolidation included four 28-day cycles of lenalidomide (25 
      mg/d on days 1 to 21 every 28 days) plus prednisone (50 mg every other day), 
      followed by maintenance with lenalidomide (LP-L; 10 mg/d on days 1 to 21) until 
      relapse. Primary end points were safety (incidence of grade 3 to 4 adverse events 
      [AEs]) and efficacy (response rate). Results A total of 102 patients were 
      enrolled. In a per-protocol analysis, after PAD, 58% of patients had very good 
      partial response (VGPR) or better, including 13% with complete response (CR); 
      after MEL100, 82% of patients had at least VGPR and 38% had CR; and after LP-L, 
      86% of patients had at least VGPR and 66% had CR. After median follow-up time of 
      21 months, the 2-year progression-free survival rate was 69%, and the 2-year 
      overall survival rate was 86%. During induction, treatment-related mortality was 
      3%; grade 3 to 4 AEs included thrombocytopenia (17%), neutropenia (10%), 
      peripheral neuropathy (16%), and pneumonia (10%). During 
      consolidation-maintenance, grade 3 to 4 AEs were neutropenia (16%), 
      thrombocytopenia (6%), pneumonia (5%), and cutaneous rash (4%). CONCLUSION 
      Bortezomib as induction before autologous transplantation, followed by 
      lenalidomide as consolidation-maintenance, is an effective regimen.
FAU - Palumbo, Antonio
AU  - Palumbo A
AD  - Divisione di Ematologia dell'Universita di Torino, Azienda 
      Ospedaliero-Universitaria San Giovanni Battista, Via Genova 3, 10126 Torino, 
      Italy. appalumbo@yahoo.com
FAU - Gay, Francesca
AU  - Gay F
FAU - Falco, Patrizia
AU  - Falco P
FAU - Crippa, Claudia
AU  - Crippa C
FAU - Montefusco, Vittorio
AU  - Montefusco V
FAU - Patriarca, Francesca
AU  - Patriarca F
FAU - Rossini, Fausto
AU  - Rossini F
FAU - Caltagirone, Simona
AU  - Caltagirone S
FAU - Benevolo, Giulia
AU  - Benevolo G
FAU - Pescosta, Norbert
AU  - Pescosta N
FAU - Guglielmelli, Tommasina
AU  - Guglielmelli T
FAU - Bringhen, Sara
AU  - Bringhen S
FAU - Offidani, Massimo
AU  - Offidani M
FAU - Giuliani, Nicola
AU  - Giuliani N
FAU - Petrucci, Maria Teresa
AU  - Petrucci MT
FAU - Musto, Pellegrino
AU  - Musto P
FAU - Liberati, Anna Marina
AU  - Liberati AM
FAU - Rossi, Giuseppe
AU  - Rossi G
FAU - Corradini, Paolo
AU  - Corradini P
FAU - Boccadoro, Mario
AU  - Boccadoro M
LA  - eng
PT  - Clinical Trial, Phase II
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20100104
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
RN  - 0 (Boronic Acids)
RN  - 0 (Protease Inhibitors)
RN  - 0 (Pyrazines)
RN  - 0 (liposomal doxorubicin)
RN  - 3WJQ0SDW1A (Polyethylene Glycols)
RN  - 4Z8R6ORS6L (Thalidomide)
RN  - 69G8BD63PP (Bortezomib)
RN  - 7S5I7G3JQL (Dexamethasone)
RN  - 80168379AG (Doxorubicin)
RN  - F0P408N6V4 (Lenalidomide)
RN  - Q41OR9510P (Melphalan)
RN  - VB0R961HZT (Prednisone)
SB  - IM
EIN - J Clin Oncol. 2010 May 1;28(13):2314
MH  - Aged
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
MH  - Boronic Acids/administration & dosage
MH  - Bortezomib
MH  - Chemotherapy, Adjuvant
MH  - Dexamethasone/administration & dosage
MH  - Disease-Free Survival
MH  - Doxorubicin/administration & dosage/analogs & derivatives
MH  - Female
MH  - Humans
MH  - Italy/epidemiology
MH  - Kaplan-Meier Estimate
MH  - Lenalidomide
MH  - Male
MH  - Melphalan/administration & dosage
MH  - Middle Aged
MH  - Multiple Myeloma/*drug therapy/mortality/*surgery
MH  - Neoadjuvant Therapy
MH  - Polyethylene Glycols/administration & dosage
MH  - Prednisone/administration & dosage
MH  - Protease Inhibitors/administration & dosage
MH  - Pyrazines/administration & dosage
MH  - *Stem Cell Transplantation
MH  - Thalidomide/administration & dosage/analogs & derivatives
MH  - Time Factors
MH  - Transplantation, Autologous
MH  - Treatment Outcome
EDAT- 2010/01/06 06:00
MHDA- 2010/03/05 06:00
CRDT- 2010/01/06 06:00
PHST- 2010/01/06 06:00 [entrez]
PHST- 2010/01/06 06:00 [pubmed]
PHST- 2010/03/05 06:00 [medline]
AID - JCO.2009.22.7561 [pii]
AID - 10.1200/JCO.2009.22.7561 [doi]
PST - ppublish
SO  - J Clin Oncol. 2010 Feb 10;28(5):800-7. doi: 10.1200/JCO.2009.22.7561. Epub 2010 
      Jan 4.