Outcomes of VD-PACE With Immunomodulatory Agent as a Salvage Therapy for Relapsed/Refractory Multiple Myeloma

The number of therapeutic options for patients with relapsed/refractory multiple myeloma (RRMM) has increased significantly. We treated 30 patients with RRMM with VD-PACE + IMiD as salvage therapy followed by high-dose chemotherapy and autologous stem-cell transplantation. VD-PACE + IMiD is an effective and tolerable salvage treatment for RRMM, with an impressive response rate in pretreated RRMM. Background: Aggressive relapsed/refractory multiple myeloma (RRMM) often requires salvage cytotoxic chemotherapy. We evaluated the efficacy and toxicity of VD-PACE (bortezomib, dexamethasone, cisplatin, doxorubicin, cyclophosphamide, etoposide) with an immunomodulatory agent (IMiD) in RRMM. Patients and Methods: We retrospectively reviewed the effectiveness and tolerability among 30 patients with RRMM receiving >= 1 cycle of VD-PACE IMiD between January 2012 to April 2019. Results: Of 30 patients, 26 (86%) had myeloma double refractory to protease inhibitors and IMiDs, and had received a median of 3 lines prior of therapy. The overall response rate was 67.7%, 13% patients experienced complete remission or better, and 13% experienced very good partial response. Median progression-free and median overall survival were 11 and 26 months, respectively. The most common grade 3 or higher adverse events were hematologic events, which were manageable. Conclusion: VD-PACE - IMiD is an effective and tolerable salvage treatment for RRMM, with an impressive response rate in pretreated RRMM. (C) 2020 Elsevier Inc. All rights reserved.