Results of novel agent-based combinations used as induction therapy: responses before and after autologous stem cell transplantation (ASCT).
| . | . | Pre-trx . | Post-trx . | . | ||
|---|---|---|---|---|---|---|
| Treatment schedule . | Pts . | ≥ PR (%) . | CR +nCR (%) . | ≥ PR (%) . | CR + nCR (%) . | Reference . |
| *Including VGPR | ||||||
| **4-year OS after 4 cycles and trx: 92% in both arms | ||||||
| †Median EFS for patients receiving trx after Len-Dex clarithromycin: 37 months | ||||||
| Trx indicates transplantation; PR, partial response; CR, complete response; nCR, near CR; Thal, thalidomide; Len, lenalidomide; Dex, dexamethasone; Cy, cyclophosphamide; Bz, bortezomid; Doxil, doxorubicin; VAD, vincristine, adriamycin, dexamethasone; TAD, thalidomide, adriamycin, dexamethasone; CTD, cyclophosphamide, thalidomide, dexamethasone; CVAD, cyclophosphamide, VAD; VBCMP, vincristine, bleomycin, chlorambucil, melphalan, prednisone; VBAD, vincristine, bleomycin, adriamycin, dexamethasone; DTPACE, cisplatin, cyclophosphamide, dexamethasone, doxorubicin, etoposide, thalidomide. | ||||||
| Thalidomide-based combinations | ||||||
| Thal-Dex vs Dex | 207 | 63 vs 41 | – | – | – | Rajkumar V et al. J Clin Oncol. 2006;24:431–436 |
| Thal-Dex vs Dex | 470 | 63 vs 46 | 7.7 vs 2.6 | – | – | Rajkumar V et ak. J Clin Oncol. 2008;26:2171–2177 |
| Thal-Dex vs VAD | 200 | 76 vs 52 | 10 vs 8 | – | – | Cavo M et al. Blood. 2005;106:35–39 |
| Thal-Dex vs VAD | 204 | 65 vs 47 | 35 vs 13* | – | 44 vs 42* | Macro M et al. Blood. 2006:108:57a |
| TAD vs VAD | 400 | 72 vs 54 | 4 vs 2 | 87 vs 79 | 30 vs 21 | Lokhorst HM et al. Haematologica2008;93:124–127. |
| T+VAD vs VAD | 230 | 81 vs 66 | 38 vs 19* | – | – | Zervas K et al. Ann Oncol. 2007;18:1369–1375 |
| CTD vs CVAD | 254 | 87 vs 75 | 19 vs 9 | 88 vs 76 | 51 vs 40 | Morgan G et al. Blood. 2007;110:3593a |
| Lenalidomide-based combinations | ||||||
| Len-Dex vs Len-Dex | 445 | 81 vs 70 | 17 vs 14 | –** | –** | Rajkumar V et al. J Clin Oncol. 2008;26:8504a |
| Len-Dex vs Dex | 198 | 85 vs 51 | 22 vs 4 | – | – | Zonder J et al. Blood. 2007;110:77a |
| Len-Dex-Clarithromycin | 72 | 90 | 46 | –† | –† | Niesvizky R et al. Blood. 2008;111:1101–1109. |
| Len-Cy-Dex | 53 | 83 | 2 | – | – | Kumar S et al. Blood. 2008;112:91a |
| Bortezomib-based combinations | ||||||
| Bz-Dex | 48 | 66 | 21 | 90 | 33 | Harousseau JL et al. Haematologica. 2006;91:1498–1505 |
| Bz-Dex (alt) | 40 | 60 | 13 | 88 | 30 | Rosiñol L et al. J Clin Oncol. 2007;25:4452–4458 |
| Bz-Doxil | 63 | 79 | 28 | – | – | Orlowski R et al. Blood. 2006;108:797a |
| Bz-Doxil-Dex | 36 | 89 | 32 | 96 | 54 | Jakubowiak AJ et al. Blood. 2006;11:3093a |
| Bz-Adriamycin | 21 | 95 | 24 | 95 | 57 | Oakervee HE et al. Br J Haematol. 2005;129:755–762 |
| Bz-Cy-Dex | 100 | 79 | 11 | – | – | Knopp S et al. Blood. 2008;112:2776a |
| Bz-Cy-Dex | 33 | 100 | 64 | – | – | Reeder CB et al. J Clin Oncol. 2008;26:8517a |
| Bz-Dex vs VAD | 482 | 82 vs 65 | 15 vs 7 | 91 vs 91 | 40 vs 22 | Harousseau JL et al. J Clin Oncol. 2008;26:8505a |
| Bz-Adriamycin-Dex vs VAD | 300 | 83 vs 59 | 5 vs 1 | 93 vs 80 | 23 vs 9 | Sonneveld P et al. Blood. 2008;112:653a |
| Bortezomib and IMID-based combinations | ||||||
| Bz-Thal-Dex | 38 | 92 | 18 | – | – | Wang M et al. Hematology. 2007;235–239 |
| Bz-DTPACE | 12 | 83 | 17 | 92 | 58 | Badros A et al. Clin Lymph Myeloma. 2006;7:210–216 |
| Bz-Thal-Dex vs Thal-Dex | 460 | 94 vs 79 | 32 vs 12 | – | 55 vs 32 | Cavo M et al. Blood. 2008;112:158a |
| VBCMP/VBAD-Bz vs Thal-Dex vs Bz-Thal-Dex | 183 | 72 vs 66 vs 80 | 28 vs 12 vs 41 | 97 vs 97 vs 97 | 54 vs 53 vs 64 | Rosiñol L et al. Blood. 2008;112:654a |
| Bz-Len-Dex | 68 | 100 | 44 | – | – | Richardson P et al. Blood. 2008;112:92a |
| Bz-Len-Cy-Dex | 25 | 100 | 36 | – | – | Kumar S et al. Blood. 2008;112:93a |
| . | . | Pre-trx . | Post-trx . | . | ||
|---|---|---|---|---|---|---|
| Treatment schedule . | Pts . | ≥ PR (%) . | CR +nCR (%) . | ≥ PR (%) . | CR + nCR (%) . | Reference . |
| *Including VGPR | ||||||
| **4-year OS after 4 cycles and trx: 92% in both arms | ||||||
| †Median EFS for patients receiving trx after Len-Dex clarithromycin: 37 months | ||||||
| Trx indicates transplantation; PR, partial response; CR, complete response; nCR, near CR; Thal, thalidomide; Len, lenalidomide; Dex, dexamethasone; Cy, cyclophosphamide; Bz, bortezomid; Doxil, doxorubicin; VAD, vincristine, adriamycin, dexamethasone; TAD, thalidomide, adriamycin, dexamethasone; CTD, cyclophosphamide, thalidomide, dexamethasone; CVAD, cyclophosphamide, VAD; VBCMP, vincristine, bleomycin, chlorambucil, melphalan, prednisone; VBAD, vincristine, bleomycin, adriamycin, dexamethasone; DTPACE, cisplatin, cyclophosphamide, dexamethasone, doxorubicin, etoposide, thalidomide. | ||||||
| Thalidomide-based combinations | ||||||
| Thal-Dex vs Dex | 207 | 63 vs 41 | – | – | – | Rajkumar V et al. J Clin Oncol. 2006;24:431–436 |
| Thal-Dex vs Dex | 470 | 63 vs 46 | 7.7 vs 2.6 | – | – | Rajkumar V et ak. J Clin Oncol. 2008;26:2171–2177 |
| Thal-Dex vs VAD | 200 | 76 vs 52 | 10 vs 8 | – | – | Cavo M et al. Blood. 2005;106:35–39 |
| Thal-Dex vs VAD | 204 | 65 vs 47 | 35 vs 13* | – | 44 vs 42* | Macro M et al. Blood. 2006:108:57a |
| TAD vs VAD | 400 | 72 vs 54 | 4 vs 2 | 87 vs 79 | 30 vs 21 | Lokhorst HM et al. Haematologica2008;93:124–127. |
| T+VAD vs VAD | 230 | 81 vs 66 | 38 vs 19* | – | – | Zervas K et al. Ann Oncol. 2007;18:1369–1375 |
| CTD vs CVAD | 254 | 87 vs 75 | 19 vs 9 | 88 vs 76 | 51 vs 40 | Morgan G et al. Blood. 2007;110:3593a |
| Lenalidomide-based combinations | ||||||
| Len-Dex vs Len-Dex | 445 | 81 vs 70 | 17 vs 14 | –** | –** | Rajkumar V et al. J Clin Oncol. 2008;26:8504a |
| Len-Dex vs Dex | 198 | 85 vs 51 | 22 vs 4 | – | – | Zonder J et al. Blood. 2007;110:77a |
| Len-Dex-Clarithromycin | 72 | 90 | 46 | –† | –† | Niesvizky R et al. Blood. 2008;111:1101–1109. |
| Len-Cy-Dex | 53 | 83 | 2 | – | – | Kumar S et al. Blood. 2008;112:91a |
| Bortezomib-based combinations | ||||||
| Bz-Dex | 48 | 66 | 21 | 90 | 33 | Harousseau JL et al. Haematologica. 2006;91:1498–1505 |
| Bz-Dex (alt) | 40 | 60 | 13 | 88 | 30 | Rosiñol L et al. J Clin Oncol. 2007;25:4452–4458 |
| Bz-Doxil | 63 | 79 | 28 | – | – | Orlowski R et al. Blood. 2006;108:797a |
| Bz-Doxil-Dex | 36 | 89 | 32 | 96 | 54 | Jakubowiak AJ et al. Blood. 2006;11:3093a |
| Bz-Adriamycin | 21 | 95 | 24 | 95 | 57 | Oakervee HE et al. Br J Haematol. 2005;129:755–762 |
| Bz-Cy-Dex | 100 | 79 | 11 | – | – | Knopp S et al. Blood. 2008;112:2776a |
| Bz-Cy-Dex | 33 | 100 | 64 | – | – | Reeder CB et al. J Clin Oncol. 2008;26:8517a |
| Bz-Dex vs VAD | 482 | 82 vs 65 | 15 vs 7 | 91 vs 91 | 40 vs 22 | Harousseau JL et al. J Clin Oncol. 2008;26:8505a |
| Bz-Adriamycin-Dex vs VAD | 300 | 83 vs 59 | 5 vs 1 | 93 vs 80 | 23 vs 9 | Sonneveld P et al. Blood. 2008;112:653a |
| Bortezomib and IMID-based combinations | ||||||
| Bz-Thal-Dex | 38 | 92 | 18 | – | – | Wang M et al. Hematology. 2007;235–239 |
| Bz-DTPACE | 12 | 83 | 17 | 92 | 58 | Badros A et al. Clin Lymph Myeloma. 2006;7:210–216 |
| Bz-Thal-Dex vs Thal-Dex | 460 | 94 vs 79 | 32 vs 12 | – | 55 vs 32 | Cavo M et al. Blood. 2008;112:158a |
| VBCMP/VBAD-Bz vs Thal-Dex vs Bz-Thal-Dex | 183 | 72 vs 66 vs 80 | 28 vs 12 vs 41 | 97 vs 97 vs 97 | 54 vs 53 vs 64 | Rosiñol L et al. Blood. 2008;112:654a |
| Bz-Len-Dex | 68 | 100 | 44 | – | – | Richardson P et al. Blood. 2008;112:92a |
| Bz-Len-Cy-Dex | 25 | 100 | 36 | – | – | Kumar S et al. Blood. 2008;112:93a |