Superiority of the triple combination of bortezomib, cyclophosphamide and dexamethasone versus cyclophosphamide, thalidomide and dexamethasone in patients with newly diagnosed multiple myeloma, eligible for transplantation

• Published in: Hematology, Transfusion and Cell Therapy Vol. 42; no. 2; pp. 118 - 124
• Main Authors: Crusoe, Edvan De Queiroz, Higashi, Fabiana, Martinez, Gracia, Bittencourt, Rosane, Pinto Neto, Jorge Vaz, Sousa, Lais, Santucci, Rodrigo, Magalhães, Roberto José Pessoa, Colli, Gilberto, Nunes, Renata Ferreira Marques, Ribeiro, Glaciano, Nicacio, Jandir, Zanella, Karla Richter, Kutner, Jose Mauro, Magalhaes, Andre, Leao, Danielle, Hallack Neto, Abrahão Elias, Braga, Walter, Souza, Emanuella G, Guimaraes, Antonio Julio A.M., Durigon, Giovanna Steffenello, Laks, Dani, Maiolino, Angelo, Hungria, Vania Tietsche de Moraes
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Elsevier España, S.L.U 01.04.2020; Sociedade Brasileira de Hematologia e Hemoterapia; Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular (ABHH); Elsevier
• Subjects: Antineoplastic combined chemotherapy protocols; Bone marrow transplantation; Bortezomib; MEDICINE, GENERAL & INTERNAL; Multiple myeloma; Original; Thalidomide; Bone marrow transplantation; Antineoplastic combined chemotherapy protocols; Bortezomib; Thalidomide; Multiple myeloma
• ISSN: 2531-1379; 2531-1387; 2531-1387
• DOI: 10.1016/j.htct.2019.05.004

The treatment of multiple myeloma (MM) has evolved significantly in the past decade, and new drug combinations have improved the response rates and prolonged survival. Studies comparing different induction chemotherapy regimens have shown that triple combinations have better results than double combinations. However, comparisons among different triple combinations are rare in the literature. We retrospectively compared two triple combinations comprising bortezomib, cyclophosphamide and dexamethasone (VCD) versus thalidomide, cyclophosphamide and dexamethasone (CTD), and aimed at identifying which of the two combinations would yield better response rates following four induction cycles prior to hematopoietic cell transplantation in patients with untreated multiple myeloma. We retrospectively reviewed the medical records of 311 patients from 24 different centers.The VCD regimen was used as induction therapy by 117 (37.6%) patients, whereas 194 (62.4%) patients received the CTD regimen. After four cycles of induction on an intention-to-treat basis, 54% of the patients in the VCD group achieved at least very good partial response versus 42.8% in the CTD group (p=0.05). We observed no difference in neuropathy or thrombotic events rates among the two regimens. Our results corroborate the superiority of the triple combination regimes containing bortezomib over the triple combination with thalidomide as pre ASCT induction therapy in MM.