Induction regimens as primary treatment in elderly patients
| Induction regimen . | N . | Maintenance regimen . | CR (%) . | ORR (%) . | PFS (months) . | Median OS (months or %) . | Reference . |
|---|---|---|---|---|---|---|---|
| Alkylator (melphalan) based | |||||||
| MPV; MP | 344; 338 | None; none | 30; 4 | 71; 35 | NA, NA | 56; 43 (P < .001) | 39 |
| VMP | 130 | Randomized to VT or VP up to 3 y | 20 | 80 | 37 | 60% at 5 y | 45 |
| VMP | 257 | None | 24 | 81 | 27 | 51% at 5 y | 47 |
| VMPT | 254 | VT up to 2 y | 38 | 89 | 37 | 61% at 5 y | 47 |
| VMP | 167 | V (5 cycles) in all arms | 32 | 69 | NA | NA | 48 |
| KMP; VMP | 478; 477 | None | 25.9; 23.1 | 84.3; 78.8 | 22.3; 22.1 | >80% at 2 y; >80% at 2 y | 49 |
| Non–alkylator based | |||||||
| Len/Dex (RD); Len/dex (Rd) | 214, 208 | None; none | 5; 4 | 81; 70 | 19; 25 (P = NS) | 75% at 2 y; 87% at 2 y (P = .00002) | 50 |
| Len/Dex (continuous Rd); Len/Dex 18 cycles; MPT | 535; 541; 547 | Len/Dex; none; none | 15; 14; 9 | 75; 73; 62 | 26; 21; 21.9 (P < .00001, Rd vs MPT) | 59.1; 62; 49.1 (P = .023, Rd vs MPT) | 42 |
| VLen/Dex × 8; Len/Dex | 264; 261 | Len/Dex; Len/Dex | 16; 8 | 82; 72 | 43; 30 (P = .0018) | 75; 64 (P = .025) | 43 |
| KRd | 23 | Len alone | 83 | 100 | 100% at 1 y | 100% at 1 y | 51 |
| Induction regimen . | N . | Maintenance regimen . | CR (%) . | ORR (%) . | PFS (months) . | Median OS (months or %) . | Reference . |
|---|---|---|---|---|---|---|---|
| Alkylator (melphalan) based | |||||||
| MPV; MP | 344; 338 | None; none | 30; 4 | 71; 35 | NA, NA | 56; 43 (P < .001) | 39 |
| VMP | 130 | Randomized to VT or VP up to 3 y | 20 | 80 | 37 | 60% at 5 y | 45 |
| VMP | 257 | None | 24 | 81 | 27 | 51% at 5 y | 47 |
| VMPT | 254 | VT up to 2 y | 38 | 89 | 37 | 61% at 5 y | 47 |
| VMP | 167 | V (5 cycles) in all arms | 32 | 69 | NA | NA | 48 |
| KMP; VMP | 478; 477 | None | 25.9; 23.1 | 84.3; 78.8 | 22.3; 22.1 | >80% at 2 y; >80% at 2 y | 49 |
| Non–alkylator based | |||||||
| Len/Dex (RD); Len/dex (Rd) | 214, 208 | None; none | 5; 4 | 81; 70 | 19; 25 (P = NS) | 75% at 2 y; 87% at 2 y (P = .00002) | 50 |
| Len/Dex (continuous Rd); Len/Dex 18 cycles; MPT | 535; 541; 547 | Len/Dex; none; none | 15; 14; 9 | 75; 73; 62 | 26; 21; 21.9 (P < .00001, Rd vs MPT) | 59.1; 62; 49.1 (P = .023, Rd vs MPT) | 42 |
| VLen/Dex × 8; Len/Dex | 264; 261 | Len/Dex; Len/Dex | 16; 8 | 82; 72 | 43; 30 (P = .0018) | 75; 64 (P = .025) | 43 |
| KRd | 23 | Len alone | 83 | 100 | 100% at 1 y | 100% at 1 y | 51 |
D, high-dose dexamethasone; d, low-dose dexamethasone; Dex, dexamethasone; K, carfilzomib; Len, lenalidomide; M, melphalan; NS, not significant; ORR, overall response rate; P, prednisone; T, thalidomide; V, bortezomib.