GEM2005 trial update comparing VMP/VTP as induction in elderly multiple myeloma patients: do we still need alkylators?

被引：81

作者：

Mateos, Maria-Victoria ^{[1
]}

Oriol, Albert ^{[2
]}

Martinez-Lopez, Joaquin ^{[3
]}

Teruel, Ana-Isabel ^{[4
]}

Lopez de la Guia, Ana ^{[5
]}

Lopez, Javier ^{[6
]}

Bengoechea, Enrique ^{[7
]}

Perez, Montserrat ^{[8
]}

Martinez, Rafael ^{[9
]}

Palomera, Luis ^{[10
]}

de Arriba, Felipe ^{[11
]}

Gonzalez, Yolanda ^{[12
]}

Mariano Hernandez, Jose ^{[13
]}

Granell, Miquel ^{[14
]}

Bello, Jose-Luis ^{[15
]}

Bargay, Joan ^{[16
]}

Penalver, Francisco-Javier ^{[17
]}

Martin-Mateos, Maria-Luisa ^{[18
]}

Paiva, Bruno ^{[19
]}

Montalban, Maria-Angeles ^{[3
]}

Blade, Joan ^{[20
,21
]}

Lahuerta, Juan-Jose ^{[3
]}

San-Miguel, Jesus F. ^{[19
]}

机构：

[1] Univ Hosp Salamanca, IBSAL, Dept Hematol, Salamanca 37007, Spain

[2] Hosp Badalona Germans Trias & Pujol, Inst Catala Oncol, Dept Hematol, Badalona, Spain

[3] Hosp 12 Octubre, Dept Hematol, E-28041 Madrid, Spain

[4] Hosp Clin Valencia, Dept Hematol, Valencia, Spain

[5] Hosp La Paz, Dept Hematol, Madrid, Spain

[6] Hosp Ramon & Cajal, Dept Hematol, E-28034 Madrid, Spain

[7] Hosp Donostia, Dept Hematol, San Sebastian, Spain

[8] Hosp Virgen de la Concha, Dept Hematol, Zamora, Spain

[9] Hosp Clin San Carlos, Dept Hematol, Madrid, Spain

[10] Hosp Lozano Blesa, Dept Hematol, Zaragoza, Spain

[11] Hosp Morales Messeguer, Dept Hematol, Murcia, Spain

[12] Inst Oncol Dr Josep Trueta, Dept Hematol, Girona, Spain

[13] Hosp Gen Segovia, Dept Hematol, Segovia, Spain

[14] Hosp Santa Creu & Sant Pau, Dept Hematol, Barcelona, Spain

[15] Complejo HospUniv Santiago, Dept Hematol, Santiago De Compostela, Spain

[16] Hosp Sont Llatzer, Dept Hematol, Palma de Mallorca, Spain

[17] Fdn Hosp Alcorcon, Dept Hematol, Madrid, Spain

[18] Hosp San Pedro Alcantara, Dept Hematol, Caceres, Spain

[19] Univ Navarra Clin, Dept Hematol, Ctr Invest Med Aplicada, Navarra, Spain

[20] Hosp Clin Barcelona, Dept Hematol, Barcelona, Spain

[21] Inst Invest Biomed August Pi & Sunyer, Dept Hematol, Barcelona, Spain

来源：

BLOOD | 2014年 / 124卷 / 12期

关键词：

BORTEZOMIB-MELPHALAN-PREDNISONE; INITIAL TREATMENT; LENALIDOMIDE; MAINTENANCE;

D O I：

10.1182/blood-2014-05-573733

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Melphalan (M), in combination with prednisone (MP), has been the backbone of new combinations, including bortezomib plus MP (VMP). However, new alkylator-free schemes, such as lenalidomide plus low-dose dexamethasone, are challenging the role of alkylators in myeloma treatment of elderly patients. Here we have updated, after a long follow-up (median 6 years), the results of the GEM2005 study that addressed this question by comparing VMP with bortezomib plus thalidomide and prednisone (VTP) as induction. Between April 2005 and October 2008, 260 patients were randomized to receive 6 cycles of VMP or VTP as induction. The median progression-free survival was 32 months for the VMP and 23 months for the VTP arms (p = .09). VMP significantly prolonged the overall survival (OS) compared with VTP (median of 63 and 43 months, respectively; hazard ratio [HR]: 0.67, p = .01). Achieving immunophenotypic complete response was associated with a significantly longer OS, especially in the VMP arm (66% remain alive after 8 years). Melphalan, plus bortezomib, should be maintained as standard care for the treatment of elderly multiple myeloma patients. This trial was registered at www.clinicaltrials.gov as #NCT00443235.

引用

页码：1887 / 1893

页数：7

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