Cyclophosphamide, bortezomib and dexamethasone induction for newly diagnosed multiple myeloma: high response rates in a phase II clinical trial
Top Cited Papers
Open Access
- 19 February 2009
- journal article
- research article
- Published by Springer Science and Business Media LLC in Leukemia
- Vol. 23 (7), 1337-1341
- https://doi.org/10.1038/leu.2009.26
Abstract
We have studied a three-drug combination with cyclophosphamide, bortezomib and dexamethasone (CyBorD) on a 28-day cycle in the treatment of newly diagnosed multiple myeloma (MM) patients to assess response and toxicity. The primary endpoint of response was evaluated after four cycles. Thirty-three newly diagnosed, symptomatic patients with MM received bortezomib 1.3 mg/m2 intravenously on days 1, 4, 8 and 11, cyclophosphamide 300 mg/m2 orally on days 1, 8, 15 and 22 and dexamethasone 40 mg orally on days 1–4, 9–12 and 17–20 on a 28-day cycle for four cycles. Responses were rapid with a mean 80% decline in the sentinel monoclonal protein at the end of two cycles. The overall intent to treat response rate (⩾ partial response) was 88%, with 61% of very good partial response or better (⩾VGPR) and 39% of complete/near complete response (CR/nCR). For the 28 patients who completed all four cycles of therapy, the CR/nCR rate was 46% and VGPR rate was 71%. All patients undergoing stem cell harvest had a successful collection. Twenty-three patients underwent stem cell transplantation (SCT) and are evaluable through day 100 with CR/nCR documented in 70% and ⩾VGPR in 74%. In conclusion, CyBorD produces a rapid and profound response in patients with newly diagnosed MM with manageable toxicity.Keywords
This publication has 33 references indexed in Scilit:
- Compromised stem cell mobilization following induction therapy with lenalidomide in myelomaLeukemia, 2008
- Long‐term outcome results of the first tandem autotransplant trial for multiple myelomaBritish Journal of Haematology, 2006
- International uniform response criteria for multiple myelomaLeukemia, 2006
- Oral melphalan and prednisone chemotherapy plus thalidomide compared with melphalan and prednisone alone in elderly patients with multiple myeloma: randomised controlled trialThe Lancet, 2006
- Phase III Clinical Trial of Thalidomide Plus Dexamethasone Compared With Dexamethasone Alone in Newly Diagnosed Multiple Myeloma: A Clinical Trial Coordinated by the Eastern Cooperative Oncology GroupJournal of Clinical Oncology, 2006
- Weekly Cyclophosphamide and Alternate-Day Prednisone: An Effective, Convenient, and Well-Tolerated Oral Treatment for Relapsed Multiple Myeloma After Autologous Stem Cell TransplantationMayo Clinic Proceedings, 2005
- Thalidomide–dexamethasone as primary therapy for advanced multiple myelomaAmerican Journal of Hematology, 2005
- Bortezomib (PS-341): A Novel, First-in-Class Proteasome Inhibitor for the Treatment of Multiple Myeloma and Other CancersCancer Control, 2003
- High-Dose Chemotherapy with Hematopoietic Stem-Cell Rescue for Multiple MyelomaThe New England Journal of Medicine, 2003
- Antitumor Activity of Thalidomide in Refractory Multiple MyelomaThe New England Journal of Medicine, 1999