A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Carfilzomib and dexamethasone maintenance following salvage ASCT in multiple myeloma: A randomised phase 2 trial by the Nordic Myeloma Study Group
Tekijät: Gregersen Henrik, Peceliunas Valdas, Remes Kari, Schjesvold Fredrik, Abildgaard Niels, Nahi Hareth, Andersen Niels Frost, Vangsted Annette Juul, Klausen Tobias Wirenfeldt, Helleberg Carsten, Carlson Kristina, Frolund Ulf Christian, Axelsson Per, Stromberg Olga, Blimark Cecilie Hveding, Crafoord Jacob, Tsykunova Galina, Eshoj Henrik Rode, Waage Anders, Hansson Markus, Gulbrandsen Nina
Kustantaja: WILEY
Julkaisuvuosi: 2022
Journal: European Journal of Haematology
Tietokannassa oleva lehden nimi: EUROPEAN JOURNAL OF HAEMATOLOGY
Lehden akronyymi: EUR J HAEMATOL
Vuosikerta: 108
Numero: 1
Aloitussivu: 34
Lopetussivu: 44
Sivujen määrä: 11
ISSN: 0902-4441
eISSN: 1600-0609
DOI: https://doi.org/10.1111/ejh.13709
Verkko-osoite: https://onlinelibrary.wiley.com/doi/full/10.1111/ejh.13709
Rinnakkaistallenteen osoite: https://research.utu.fi/converis/portal/detail/Publication/67656258
Objective: We investigated the efficacy and safety of carfilzomib-containing induction before salvage high-dose melphalan with autologous stem-cell transplantation (salvage ASCT) and maintenance with carfilzomib and dexamethasone after salvage ASCT in multiple myeloma.
Methods: This randomised, open-label, phase 2 trial included patients with first relapse of multiple myeloma after upfront ASCT who were re-induced with four cycles of carfilzomib, cyclophosphamide and dexamethasone. Two months after salvage, ASCT patients were randomised to either observation or maintenance therapy with iv carfilzomib 27 -> 56 mg/sqm and p.o. dexamethasone 20 mg every second week. The study enrolled 200 patients of which 168 were randomised to either maintenance with carfilzomib and dexamethasone (n = 82) or observation (n = 86).
Results: Median time to progression (TTP) after randomisation was 25.1 months (22.5-NR) in the carfilzomib-dexamethasone maintenance group and 16.7 months (14.4-21.8) in the control group (HR 0.46, 95% CI 0.30-0.71; P = .0004). The most common adverse events during maintenance were thrombocytopenia, anaemia, hypertension, dyspnoea and bacterial infections.
Conclusion: In summary, maintenance therapy with carfilzomib and dexamethasone after salvage ASCT prolonged TTP with 8 months. The maintenance treatment was in general well-tolerated with manageable toxicity.
Ladattava julkaisu This is an electronic reprint of the original article. |  |
