PMID- 33496996 OWN - NLM STAT- MEDLINE DCOM- 20210728 LR - 20210917 IS - 1600-0609 (Electronic) IS - 0902-4441 (Linking) VI - 106 IP - 4 DP - 2021 Apr TI - Efficacy and tolerability of VCD chemotherapy in a UK real-world dataset of elderly transplant-ineligible newly diagnosed myeloma patients. PG - 563-573 LID - 10.1111/ejh.13588 [doi] AB - OBJECTIVE: There are limited data on the efficacy and tolerability of VCD chemotherapy in transplant-non-eligible (TNE) newly diagnosed myeloma (NDMM) patients. In this retrospective study, we set out to evaluate this triplet combination in this setting across Thames Valley Cancer Network (UK). METHODS: The primary end point was overall response rate (ORR). Secondary outcomes included event-free survival (EFS), overall survival (OS) and adverse events (AEs). RESULTS: In a total cohort of 158 patients, ORR for total cohort was 72.1%. Median EFS was 10.5 months, and for subgroups by age (<75:11.7 vs >/=75:10.3 months, P = .124), by Charlson Co-morbidity Index (CCI) (<5:11.1 vs >/=5:8.2 months, P = .345). The 4-month landmark analysis showed the following median EFS results: by cumulative bortezomib dose (>/=26 mg/m(2) : 9.0 months vs <26 mg/m(2) : 6.4, P = .13), by cumulative cyclophosphamide dose (>/=7000 mg: 9.2 vs <7000 mg: 7.0 months, P = .02) and by cumulative dexamethasone dose (>600 mg: 7.8 vs /=G3 (27.1%), >/=G3 haematological AEs (7.9%), any grade infections (31.1%) and >/=G3 infections (11.9%). CONCLUSION: This study demonstrated a good ORR achieved from fixed duration VCD, which was reasonably well tolerated. This was followed by modest median EFS. We envisage that the latter may be improved in this patient group with the use of a higher cumulative bortezomib dose (>/=26 mg/m(2) ) which showed a trend for improved EFS although without statistical significance (P = .13), and with the use of a higher cumulative cyclophosphamide doses (>/=7000 mg, P = .02), subject to tolerability and close monitoring. CI - (c) 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. FAU - Rampotas, Alexandros AU - Rampotas A AUID- ORCID: 0000-0002-2681-5860 AD - Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. AD - Oxford University Clinical Academic Graduate School, Oxford, UK. FAU - Djebbari, Faouzi AU - Djebbari F AUID- ORCID: 0000-0001-9578-7632 AD - Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. FAU - Panitsas, Fotios AU - Panitsas F AD - Department of Haematology, Laiko General Hospital, Athens, Greece. FAU - Lees, Charlotte AU - Lees C AD - Royal Berkshire NHS Foundation Trust, Reading, UK. FAU - Tsagkaraki, Ismini AU - Tsagkaraki I AD - Buckinghamshire Healthcare NHS Trust, Aylesbury, UK. FAU - Gomes, Ana Rita AU - Gomes AR AD - Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. FAU - Prideaux, Steve AU - Prideaux S AD - Great Western Hospitals NHS Foundation Trust, Swindon, UK. FAU - Chen, Lucia AU - Chen L AD - Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK. FAU - Prodger, Catherine AU - Prodger C AD - Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. FAU - Khera, Akhil AU - Khera A AD - Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. FAU - Gray, Nicola AU - Gray N AD - Wexham Park Hospital, Slough, UK. FAU - Ellis, Lauren AU - Ellis L AD - Frimley Health NHS Foundation Trust, Frimley, UK. FAU - Sangha, Gavinda AU - Sangha G AD - Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. FAU - Lim, Wen Yuen AU - Lim WY AD - Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. FAU - Eyre, Toby A AU - Eyre TA AD - Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. FAU - Moore, Sally AU - Moore S AD - Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. FAU - Ramasamy, Karthik AU - Ramasamy K AD - Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. FAU - Kothari, Jaimal AU - Kothari J AD - Department of Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. LA - eng PT - Journal Article DEP - 20210205 PL - England TA - Eur J Haematol JT - European journal of haematology JID - 8703985 RN - 7S5I7G3JQL (Dexamethasone) RN - 8N3DW7272P (Cyclophosphamide) RN - 957E6438QA (Teniposide) RN - VCD protocol SB - IM CIN - Eur J Haematol. 2021 Oct;107(4):497-499. PMID: 34129711 MH - Aged MH - Aged, 80 and over MH - Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use MH - Clinical Decision-Making MH - Cyclophosphamide/adverse effects/therapeutic use MH - Dexamethasone/adverse effects/therapeutic use MH - Disease Management MH - Female MH - Health Care Surveys MH - Humans MH - Male MH - Middle Aged MH - Multiple Myeloma/diagnosis/*drug therapy/*epidemiology/mortality MH - Prognosis MH - Teniposide/adverse effects/therapeutic use MH - Treatment Outcome MH - United Kingdom/epidemiology OTO - NOTNLM OT - bortezomib OT - co-morbidities OT - cumulative dose OT - elderly OT - myeloma EDAT- 2021/01/27 06:00 MHDA- 2021/07/29 06:00 CRDT- 2021/01/26 12:13 PHST- 2020/11/30 00:00 [received] PHST- 2021/01/19 00:00 [revised] PHST- 2021/01/21 00:00 [accepted] PHST- 2021/01/27 06:00 [pubmed] PHST- 2021/07/29 06:00 [medline] PHST- 2021/01/26 12:13 [entrez] AID - 10.1111/ejh.13588 [doi] PST - ppublish SO - Eur J Haematol. 2021 Apr;106(4):563-573. doi: 10.1111/ejh.13588. Epub 2021 Feb 5.