Weekly intravenous bortezomib is effective and well tolerated in relapsed/refractory myeloma
Weekly intravenous bortezomib is effective and well tolerated in relapsed/refractory myeloma
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DOI：
10.1111/ejh.12070
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发表时间：
2013-05-01
影响因子：
3.1
通讯作者：
Yong, Kwee
中科院分区：
文献类型：
--
作者：
Moore, Sally;Atwal, Sangeeta;Yong, Kwee
目的硼替佐米是一种有效的抗骨髓瘤治疗药物，但其神经毒性限制了其临床疗效。在新诊断的老年患者中，将每两周一次给药方案修改为每周一次方案可改善耐受性，同时保持疗效。关于每周一次硼替佐米治疗复发/难治性疾病的疗效和耐受性的信息较少。在这里，我们报告我们的经验，每周静脉硼替佐米在复发/难治性患者的临床实践。方法我们分析了52例每周硼替佐米复发/难治性MM。结果31%的患者接受硼替佐米超过第一次复发。几乎所有（94%）也接受了类固醇，48%也接受了烷化剂。中位累积剂量为22.6mg/m2，中位治疗时间为164天。3例患者报告2级感觉神经病变，1例报告3级运动神经病变。无4级神经毒性。83%达到PR或更高，整个组的中位PFS为13个月。1年PFS和OS分别为53%（95% CI 3966.6%）和78%（95% CI 66.789.6%）。结论：每周静脉硼替佐米联合类固醇+/-烷化剂治疗复发/难治性MM有效，其结局与每两周一次方案相当，周围神经病变发生率较低。
Objectives Bortezomib is an effective antimyeloma therapy, but clinical benefits can be limited by neurotoxicity. In newly diagnosed, older patients, modification of the biweekly dosing schedule to weekly regimens improves tolerability whilst maintaining efficacy. There is less information on the efficacy and tolerability of weekly bortezomib regimens in the relapsed/refractory setting. Here, we report our experience of weekly intravenous bortezomib in clinical practice in relapsed/refractory patients. Methods We analysed fifty-two patients who received weekly bortezomib for relapsed/refractory MM. Results Thirty-one per cent of patients received bortezomib beyond first relapse. Almost all (94%) also received steroids and 48% also received an alkylator. The median cumulative dose was 22.6mg/m2, and median length of treatment was 164d. Three patients reported grade 2 sensory neuropathy, and one reported grade 3 motor neuropathy. There were no grade 4 neurotoxicities. Eighty-three per cent achieved a PR or greater, and the median PFS for the whole group was 13months. One-year PFS and OS were 53% (95% CI 3966.6%) and 78% (95% CI 66.789.6%), respectively. Conclusions Weekly intravenous bortezomib when used in combination with steroids +/- alkylator is effective in relapsed/refractory MM, producing outcomes comparable with biweekly regimens and with lower rates of peripheral neuropathy.