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Clin Lymphoma Myeloma Leuk. 2016 Jul;16(7):387-94. doi: 10.1016/j.clml.2016.04.012. Epub 2016 May 10.

Cyclophosphamide and Bortezomib With Prednisone or Dexamethasone for the Treatment of Relapsed and Refractory Multiple Myeloma.

Author information

1
Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada. Electronic address: donna.reece@uhn.ca.
2
Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada.
3
Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada.

Abstract

INTRODUCTION:

Cyclophosphamide, bortezomib, and prednisone (CyBorP) is a highly effective, well-tolerated regimen in relapsed/refractory multiple myeloma. CyBorP, originally developed at our center to include weekly bortezomib (Bor) and alternate-day prednisone (P), was recently modified so that weekly dexamethasone (D) replaced prednisone.

PATIENTS AND METHODS:

To assess the effectiveness and tolerability of CyBorP/D in real-world practice, we identified 96 relapsed/refractory patients who received ≥ 1 28-day cycle of CyBorP/D, consisting of cyclophosphamide 300 mg/m(2) (days 1, 8, 15, and 22), Bor 1.0 to 1.5 mg/m(2) (days 1, 8, and 15), and either P 50 to 100 mg on alternate days or D 20 to 40 mg weekly between 2007 and 2013.

RESULTS:

Sixty-six (69%) patients achieved ≥ partial response: 16 with clinical complete response and 25 with very good partial response; 22 others had stable disease. Progression-free and overall survival for all patients were 16.2 months (95% confidence interval [CI], 7.7-20.1 months) and 26.3 months (95% CI, 21.6-81.2 months), respectively. Although 26 patients had prior Bor exposure, there was no difference in progression-free or overall survival versus Bor-naive patients.

CONCLUSION:

Toxicities with CyBorP/D were generally mild and manageable. New onset peripheral neuropathy was seen in 13 cases; 9 of 26 patients with pre-existing peripheral neuropathy developed worsening symptoms. No second primary malignancies were observed.

KEYWORDS:

Alkylator; Proteosome inhibitor; Salvage ASCT; Steroids; Survival

PMID:
27349765
DOI:
10.1016/j.clml.2016.04.012
[Indexed for MEDLINE]

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