Efficacy of regimens used as front-line treatment in elderly patients with multiple myeloma.
| Regimen . | . | N . | CR, % . | ≥ PR, % . | PFS/EFS/ TTP, % . | OS, % . | Study . |
|---|---|---|---|---|---|---|---|
| †Updated information was presented at the meetings of the American Society of Clinical Oncology, European Haematology Association and American Society of Hematology congress. | |||||||
| N indicates number of patients; CR, complete response; PR, partial response; PFS, progression-free survival; EFS, event-free survival; TTP, time to progression; OS, overall survival; Mel, melphalan; Pdn, prednisone; Thal, thalidomide; Bor, bortezomib; Len, lenalidomide; Ctx, cyclophosphamide; MPT, melphalan-prednisone-thalidomide; VMP, bortezomib-melphalan-prednisone; VTP, bortezomib-thalidomide-prednisone; VMPT, bortezomib-melphalan-prednisone-thalidomide; CTD, cyclophosphamide-thalidomide-dexamethasone; MPR, melphalan-prednisone-lenalidomide; Rd, lenalidomide- low-dose dexamethasone; ND, not determined. | |||||||
| MPT | Mel: 4 mg/m2 days 1–7 Pdn: 40 mg/m2 days 1–7 for six 4-week cycles Thal: 100 mg/day until PD | 129 | 16 | 76 | 50 at 22 mo | 50 at 45 mo | Palumbo et al19,20 |
| MPT | Mel: 0.25 mg/kg days 1–4 Pdn: 2 mg/kg days 1–4 Thal: 400 mg/day for 12 6-week cycles | 125 | 13 | 76 | 50 at 28 mo | 50 at 52 mo | Facon et al21 |
| MPT | Mel: 0.25 mg/kg days 1–4 Pdn: 2 mg/kg days 1–4 Thal: 100 mg/day for 12 6-week cycles | 113 | 7 | 62 | 50 at 24 mo | 50 at 45 mo | Hulin et al22 |
| MPT | Mel: 0.25 mg/kg days 1–4 Pdn: 100 mg days 1–4 Thal: 200–400 mg/day in a 6-week cycle until plateau Thal: 200 mg/day until disease progression | 182 | 6 | 42 | 50 at 20 mo | 50 at 29 mo | Gulbrandsen et al18† |
| MPT | Mel: 0.25 mg/kg Pdn: 1 mg/kg days 1–5 Thal: 200 mg/day for eight 4-week cycles, followed by Thal: 50 mg/day until disease progression | 165 | 2 | 66 | 50 at 14 mo | 50 at 37 mo | Wijermans et al23† |
| VMP | Mel: 9 mg/m2 days 1–4 Pdn: 60 mg/m2 days 1–4 Bor: 1.3 mg/m2 days 1,4,8,11,22,25,29,32 for the first four 6-week cycles; days 1,8,15, 22 for the subsequent five 6-week cycles | 344 | 30 | 71 | 50 at 24 mo | 72 at 36 mo | S Miguel et al25,26† |
| VMP | Mel: 9 mg/m2 days 1–4 Pdn: 60 mg/m2 days 1–4 Bor: 1.3 mg/m2 days 1,8,15,22 Thal: 50 mg days 1–42 for nine 5-week cycles | 177 | 20 | 82 | 70 at 36 mo | 87 at 36 mo | Palumbo et al28† |
| VMP | Mel: 9 mg/m2 days 1–4 Pdn: 60 mg/m2 days 1–4 Bor: 1.3 mg/m2 twice weekly (days 1, 4, 8, 11; 22, 25, 29 and 32) for one 6-week cycle, followed by once weekly (days 1, 8, 15 and 22) for five 5-week cycles | 130 | 22 | 81 | 72 at 24 mo | 88 at 24 mo | Mateos et al27† |
| VTP | Thal: 100 mg/day Pdn: 60 mg/m2 days 1–4 Bor: 1.3 mg/m2 twice weekly (days 1, 4, 8, 11; 22, 25, 29, and 32) for one 6-week cycle, followed by once weekly (days 1, 8, 15, and 22) for five 5-week cycles | 130 | 27 | 81 | 65 at 24 mo | 93 at 24 mo | Mateos et al27† |
| CTD | Ctx: 500 mg days 1,8,15 Thal: 100–200 mg/day Dex: 40 mg days 1–4, 12–15 in a 3-week cycles | 450 | 23 | 82 | ND | ND | Morgan et al29 |
| VMPT | Mel: 9 mg/m2 days 1–4 Pdn: 60 mg/m2 days 1–4 Bor: 1.3 mg/m2 days 1,8,15,22 Thal: 50 mg days 1–42 for nine 5-week cycles followed by Bor: 1.3 mg/m2 every 15 days and Thal: 50 mg/day as maintenance | 152 | 39 | 87 | 74 at 36 mo | 88 at 36 mo | Palumbo et al28† |
| MPR | Mel: 0.18–0.25 mg/kg days 1–4 Pdn: 2 mg/kg days 1–4 for nine 4-week cycles Len: 5–10 mg days 1–21 until relapse or progressive disease | 54 | 24 | 81 | 80 at 24 mo | 91 at 24 mo | Palumbo et al30,31† |
| Rd | Len: 25 mg days 1–21 Dex: 40 mg days 1, 8, 15, 22 in a 4-week cycles | 220 | ND | 70 | ND | 87 at 24 mp | Rajkumar et al17 |
| Regimen . | . | N . | CR, % . | ≥ PR, % . | PFS/EFS/ TTP, % . | OS, % . | Study . |
|---|---|---|---|---|---|---|---|
| †Updated information was presented at the meetings of the American Society of Clinical Oncology, European Haematology Association and American Society of Hematology congress. | |||||||
| N indicates number of patients; CR, complete response; PR, partial response; PFS, progression-free survival; EFS, event-free survival; TTP, time to progression; OS, overall survival; Mel, melphalan; Pdn, prednisone; Thal, thalidomide; Bor, bortezomib; Len, lenalidomide; Ctx, cyclophosphamide; MPT, melphalan-prednisone-thalidomide; VMP, bortezomib-melphalan-prednisone; VTP, bortezomib-thalidomide-prednisone; VMPT, bortezomib-melphalan-prednisone-thalidomide; CTD, cyclophosphamide-thalidomide-dexamethasone; MPR, melphalan-prednisone-lenalidomide; Rd, lenalidomide- low-dose dexamethasone; ND, not determined. | |||||||
| MPT | Mel: 4 mg/m2 days 1–7 Pdn: 40 mg/m2 days 1–7 for six 4-week cycles Thal: 100 mg/day until PD | 129 | 16 | 76 | 50 at 22 mo | 50 at 45 mo | Palumbo et al19,20 |
| MPT | Mel: 0.25 mg/kg days 1–4 Pdn: 2 mg/kg days 1–4 Thal: 400 mg/day for 12 6-week cycles | 125 | 13 | 76 | 50 at 28 mo | 50 at 52 mo | Facon et al21 |
| MPT | Mel: 0.25 mg/kg days 1–4 Pdn: 2 mg/kg days 1–4 Thal: 100 mg/day for 12 6-week cycles | 113 | 7 | 62 | 50 at 24 mo | 50 at 45 mo | Hulin et al22 |
| MPT | Mel: 0.25 mg/kg days 1–4 Pdn: 100 mg days 1–4 Thal: 200–400 mg/day in a 6-week cycle until plateau Thal: 200 mg/day until disease progression | 182 | 6 | 42 | 50 at 20 mo | 50 at 29 mo | Gulbrandsen et al18† |
| MPT | Mel: 0.25 mg/kg Pdn: 1 mg/kg days 1–5 Thal: 200 mg/day for eight 4-week cycles, followed by Thal: 50 mg/day until disease progression | 165 | 2 | 66 | 50 at 14 mo | 50 at 37 mo | Wijermans et al23† |
| VMP | Mel: 9 mg/m2 days 1–4 Pdn: 60 mg/m2 days 1–4 Bor: 1.3 mg/m2 days 1,4,8,11,22,25,29,32 for the first four 6-week cycles; days 1,8,15, 22 for the subsequent five 6-week cycles | 344 | 30 | 71 | 50 at 24 mo | 72 at 36 mo | S Miguel et al25,26† |
| VMP | Mel: 9 mg/m2 days 1–4 Pdn: 60 mg/m2 days 1–4 Bor: 1.3 mg/m2 days 1,8,15,22 Thal: 50 mg days 1–42 for nine 5-week cycles | 177 | 20 | 82 | 70 at 36 mo | 87 at 36 mo | Palumbo et al28† |
| VMP | Mel: 9 mg/m2 days 1–4 Pdn: 60 mg/m2 days 1–4 Bor: 1.3 mg/m2 twice weekly (days 1, 4, 8, 11; 22, 25, 29 and 32) for one 6-week cycle, followed by once weekly (days 1, 8, 15 and 22) for five 5-week cycles | 130 | 22 | 81 | 72 at 24 mo | 88 at 24 mo | Mateos et al27† |
| VTP | Thal: 100 mg/day Pdn: 60 mg/m2 days 1–4 Bor: 1.3 mg/m2 twice weekly (days 1, 4, 8, 11; 22, 25, 29, and 32) for one 6-week cycle, followed by once weekly (days 1, 8, 15, and 22) for five 5-week cycles | 130 | 27 | 81 | 65 at 24 mo | 93 at 24 mo | Mateos et al27† |
| CTD | Ctx: 500 mg days 1,8,15 Thal: 100–200 mg/day Dex: 40 mg days 1–4, 12–15 in a 3-week cycles | 450 | 23 | 82 | ND | ND | Morgan et al29 |
| VMPT | Mel: 9 mg/m2 days 1–4 Pdn: 60 mg/m2 days 1–4 Bor: 1.3 mg/m2 days 1,8,15,22 Thal: 50 mg days 1–42 for nine 5-week cycles followed by Bor: 1.3 mg/m2 every 15 days and Thal: 50 mg/day as maintenance | 152 | 39 | 87 | 74 at 36 mo | 88 at 36 mo | Palumbo et al28† |
| MPR | Mel: 0.18–0.25 mg/kg days 1–4 Pdn: 2 mg/kg days 1–4 for nine 4-week cycles Len: 5–10 mg days 1–21 until relapse or progressive disease | 54 | 24 | 81 | 80 at 24 mo | 91 at 24 mo | Palumbo et al30,31† |
| Rd | Len: 25 mg days 1–21 Dex: 40 mg days 1, 8, 15, 22 in a 4-week cycles | 220 | ND | 70 | ND | 87 at 24 mp | Rajkumar et al17 |