Bortezomib-based induction, high-dose melphalan and lenalidomide maintenance in myeloma up to 70 years of age
Intensive upfront therapy in newly-diagnosed multiple myeloma (MM) including induction therapy (IT), high-dose melphalan (MEL200), and autologous blood stem cell transplantation (ASCT) followed by consolidation and/or maintenance is mostly restricted to patients up to 65 years of age. Prospective ph...
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| Veröffentlicht in: | Leukemia 2021-03, Vol.35 (3), p.809-822 |
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| creator | Mai, Elias K. Miah, Kaya Bertsch, Uta Dürig, Jan Scheid, Christof Weisel, Katja C. Kunz, Christina Munder, Markus Lindemann, Hans-Walter Merz, Maximilian Hose, Dirk Jauch, Anna Seckinger, Anja Luntz, Steffen Sauer, Sandra Fuhrmann, Stephan Brossart, Peter Elmaagacli, Ahmet Goerner, Martin Bernhard, Helga Hoffmann, Martin Raab, Marc S. Blau, Igor W. Hänel, Mathias Benner, Axel Salwender, Hans J. Goldschmidt, Hartmut |
| description | Intensive upfront therapy in newly-diagnosed multiple myeloma (MM) including induction therapy (IT), high-dose melphalan (MEL200), and autologous blood stem cell transplantation (ASCT) followed by consolidation and/or maintenance is mostly restricted to patients up to 65 years of age. Prospective phase III trial data in the era of novel agents for patients up to 70 years of age are not available. The GMMG-MM5 trial included 601 patients between 18 and 70 years of age, divided in three groups for the present analysis: ≤60 years (S1,
n
= 353), 61–65 years (S2,
n
= 107) and 66–70 years (S3,
n
= 141). Treatment consisted of a bortezomib-containing IT, MEL200/ASCT, consolidation, and maintenance with lenalidomide. Adherence to treatment was similar among patients of the three age groups. Overall toxicity during all treatment phases was increased in S2 and S3 compared to S1 (any adverse event/any serious adverse event: S1:81.7/41.8% vs. S2:90.7/56.5% vs. S3:87.2/68.1%,
p
= 0.05/ |
| doi_str_mv | 10.1038/s41375-020-0976-9 |
| format | Article |
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n
= 353), 61–65 years (S2,
n
= 107) and 66–70 years (S3,
n
= 141). Treatment consisted of a bortezomib-containing IT, MEL200/ASCT, consolidation, and maintenance with lenalidomide. Adherence to treatment was similar among patients of the three age groups. Overall toxicity during all treatment phases was increased in S2 and S3 compared to S1 (any adverse event/any serious adverse event: S1:81.7/41.8% vs. S2:90.7/56.5% vs. S3:87.2/68.1%,
p
= 0.05/<0.001). With respect to progression-free survival (log-rank
p
= 0.73), overall survival (log-rank
p
= 0.54) as well as time-to-progression (Gray’s
p
= 0.83) and non-relapse mortality (Gray’s
p
= 0.25), no differences were found between the three age groups. Our results imply that an intensive upfront therapy with a bortezomib-containing IT, MEL200/ASCT, lenalidomide consolidation, and maintenance should be applied to transplant-eligible MM patients up to 70 years of age.</description><identifier>ISSN: 0887-6924</identifier><identifier>EISSN: 1476-5551</identifier><identifier>DOI: 10.1038/s41375-020-0976-9</identifier><identifier>PMID: 32684633</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/308/2171 ; 692/308/2779/777 ; 692/699/1541/1990/804 ; Adult ; Age ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Autografts ; Bortezomib ; Bortezomib - administration & dosage ; Cancer Research ; Consolidation ; Consolidation Chemotherapy - mortality ; Critical Care Medicine ; Development and progression ; Dose-response relationship (Biochemistry) ; Drug therapy ; Female ; Follow-Up Studies ; Hematology ; Hematopoietic stem cells ; Humans ; Immunotherapy ; Induction Chemotherapy - mortality ; Induction therapy ; Inhibitor drugs ; Intensive ; Internal Medicine ; Lenalidomide - administration & dosage ; Maintenance ; Male ; Medicine ; Medicine & Public Health ; Melphalan ; Middle Aged ; Multiple myeloma ; Multiple Myeloma - drug therapy ; Multiple Myeloma - pathology ; Oncology ; Patient outcomes ; Prognosis ; Prospective Studies ; Stem cell transplantation ; Stem cells ; Survival ; Survival Rate ; Targeted cancer therapy ; Therapy ; Toxicity ; Transplantation ; Transplants & implants</subject><ispartof>Leukemia, 2021-03, Vol.35 (3), p.809-822</ispartof><rights>The Author(s) 2020</rights><rights>COPYRIGHT 2021 Nature Publishing Group</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c568t-2b684d681a84f07a6bde3f8372a7bc3acb3f22147f67b99f15d777cdce02a0b23</citedby><cites>FETCH-LOGICAL-c568t-2b684d681a84f07a6bde3f8372a7bc3acb3f22147f67b99f15d777cdce02a0b23</cites><orcidid>0000-0002-7238-6956 ; 0000-0002-6226-1252 ; 0000-0003-0961-0035</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/s41375-020-0976-9$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/s41375-020-0976-9$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,777,781,882,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32684633$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mai, Elias K.</creatorcontrib><creatorcontrib>Miah, Kaya</creatorcontrib><creatorcontrib>Bertsch, Uta</creatorcontrib><creatorcontrib>Dürig, Jan</creatorcontrib><creatorcontrib>Scheid, Christof</creatorcontrib><creatorcontrib>Weisel, Katja C.</creatorcontrib><creatorcontrib>Kunz, Christina</creatorcontrib><creatorcontrib>Munder, Markus</creatorcontrib><creatorcontrib>Lindemann, Hans-Walter</creatorcontrib><creatorcontrib>Merz, Maximilian</creatorcontrib><creatorcontrib>Hose, Dirk</creatorcontrib><creatorcontrib>Jauch, Anna</creatorcontrib><creatorcontrib>Seckinger, Anja</creatorcontrib><creatorcontrib>Luntz, Steffen</creatorcontrib><creatorcontrib>Sauer, Sandra</creatorcontrib><creatorcontrib>Fuhrmann, Stephan</creatorcontrib><creatorcontrib>Brossart, Peter</creatorcontrib><creatorcontrib>Elmaagacli, Ahmet</creatorcontrib><creatorcontrib>Goerner, Martin</creatorcontrib><creatorcontrib>Bernhard, Helga</creatorcontrib><creatorcontrib>Hoffmann, Martin</creatorcontrib><creatorcontrib>Raab, Marc S.</creatorcontrib><creatorcontrib>Blau, Igor W.</creatorcontrib><creatorcontrib>Hänel, Mathias</creatorcontrib><creatorcontrib>Benner, Axel</creatorcontrib><creatorcontrib>Salwender, Hans J.</creatorcontrib><creatorcontrib>Goldschmidt, Hartmut</creatorcontrib><creatorcontrib>German-speaking Myeloma Multicenter Group (GMMG)</creatorcontrib><creatorcontrib>for the German-speaking Myeloma Multicenter Group (GMMG)</creatorcontrib><title>Bortezomib-based induction, high-dose melphalan and lenalidomide maintenance in myeloma up to 70 years of age</title><title>Leukemia</title><addtitle>Leukemia</addtitle><addtitle>Leukemia</addtitle><description>Intensive upfront therapy in newly-diagnosed multiple myeloma (MM) including induction therapy (IT), high-dose melphalan (MEL200), and autologous blood stem cell transplantation (ASCT) followed by consolidation and/or maintenance is mostly restricted to patients up to 65 years of age. Prospective phase III trial data in the era of novel agents for patients up to 70 years of age are not available. The GMMG-MM5 trial included 601 patients between 18 and 70 years of age, divided in three groups for the present analysis: ≤60 years (S1,
n
= 353), 61–65 years (S2,
n
= 107) and 66–70 years (S3,
n
= 141). Treatment consisted of a bortezomib-containing IT, MEL200/ASCT, consolidation, and maintenance with lenalidomide. Adherence to treatment was similar among patients of the three age groups. Overall toxicity during all treatment phases was increased in S2 and S3 compared to S1 (any adverse event/any serious adverse event: S1:81.7/41.8% vs. S2:90.7/56.5% vs. S3:87.2/68.1%,
p
= 0.05/<0.001). With respect to progression-free survival (log-rank
p
= 0.73), overall survival (log-rank
p
= 0.54) as well as time-to-progression (Gray’s
p
= 0.83) and non-relapse mortality (Gray’s
p
= 0.25), no differences were found between the three age groups. Our results imply that an intensive upfront therapy with a bortezomib-containing IT, MEL200/ASCT, lenalidomide consolidation, and maintenance should be applied to transplant-eligible MM patients up to 70 years of age.</description><subject>692/308/2171</subject><subject>692/308/2779/777</subject><subject>692/699/1541/1990/804</subject><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Autografts</subject><subject>Bortezomib</subject><subject>Bortezomib - administration & dosage</subject><subject>Cancer Research</subject><subject>Consolidation</subject><subject>Consolidation Chemotherapy - mortality</subject><subject>Critical Care Medicine</subject><subject>Development and progression</subject><subject>Dose-response relationship (Biochemistry)</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hematology</subject><subject>Hematopoietic stem cells</subject><subject>Humans</subject><subject>Immunotherapy</subject><subject>Induction Chemotherapy - mortality</subject><subject>Induction therapy</subject><subject>Inhibitor drugs</subject><subject>Intensive</subject><subject>Internal Medicine</subject><subject>Lenalidomide - administration & dosage</subject><subject>Maintenance</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Melphalan</subject><subject>Middle Aged</subject><subject>Multiple myeloma</subject><subject>Multiple Myeloma - drug therapy</subject><subject>Multiple Myeloma - pathology</subject><subject>Oncology</subject><subject>Patient outcomes</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Stem cell transplantation</subject><subject>Stem cells</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Targeted cancer therapy</subject><subject>Therapy</subject><subject>Toxicity</subject><subject>Transplantation</subject><subject>Transplants & 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Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Leukemia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mai, Elias K.</au><au>Miah, Kaya</au><au>Bertsch, Uta</au><au>Dürig, Jan</au><au>Scheid, Christof</au><au>Weisel, Katja C.</au><au>Kunz, Christina</au><au>Munder, Markus</au><au>Lindemann, Hans-Walter</au><au>Merz, Maximilian</au><au>Hose, Dirk</au><au>Jauch, Anna</au><au>Seckinger, Anja</au><au>Luntz, Steffen</au><au>Sauer, Sandra</au><au>Fuhrmann, Stephan</au><au>Brossart, Peter</au><au>Elmaagacli, Ahmet</au><au>Goerner, Martin</au><au>Bernhard, Helga</au><au>Hoffmann, Martin</au><au>Raab, Marc S.</au><au>Blau, Igor W.</au><au>Hänel, Mathias</au><au>Benner, Axel</au><au>Salwender, Hans J.</au><au>Goldschmidt, Hartmut</au><aucorp>German-speaking Myeloma Multicenter Group (GMMG)</aucorp><aucorp>for the German-speaking Myeloma Multicenter Group (GMMG)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bortezomib-based induction, high-dose melphalan and lenalidomide maintenance in myeloma up to 70 years of age</atitle><jtitle>Leukemia</jtitle><stitle>Leukemia</stitle><addtitle>Leukemia</addtitle><date>2021-03-01</date><risdate>2021</risdate><volume>35</volume><issue>3</issue><spage>809</spage><epage>822</epage><pages>809-822</pages><issn>0887-6924</issn><eissn>1476-5551</eissn><abstract>Intensive upfront therapy in newly-diagnosed multiple myeloma (MM) including induction therapy (IT), high-dose melphalan (MEL200), and autologous blood stem cell transplantation (ASCT) followed by consolidation and/or maintenance is mostly restricted to patients up to 65 years of age. Prospective phase III trial data in the era of novel agents for patients up to 70 years of age are not available. The GMMG-MM5 trial included 601 patients between 18 and 70 years of age, divided in three groups for the present analysis: ≤60 years (S1,
n
= 353), 61–65 years (S2,
n
= 107) and 66–70 years (S3,
n
= 141). Treatment consisted of a bortezomib-containing IT, MEL200/ASCT, consolidation, and maintenance with lenalidomide. Adherence to treatment was similar among patients of the three age groups. Overall toxicity during all treatment phases was increased in S2 and S3 compared to S1 (any adverse event/any serious adverse event: S1:81.7/41.8% vs. S2:90.7/56.5% vs. S3:87.2/68.1%,
p
= 0.05/<0.001). With respect to progression-free survival (log-rank
p
= 0.73), overall survival (log-rank
p
= 0.54) as well as time-to-progression (Gray’s
p
= 0.83) and non-relapse mortality (Gray’s
p
= 0.25), no differences were found between the three age groups. Our results imply that an intensive upfront therapy with a bortezomib-containing IT, MEL200/ASCT, lenalidomide consolidation, and maintenance should be applied to transplant-eligible MM patients up to 70 years of age.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>32684633</pmid><doi>10.1038/s41375-020-0976-9</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-7238-6956</orcidid><orcidid>https://orcid.org/0000-0002-6226-1252</orcidid><orcidid>https://orcid.org/0000-0003-0961-0035</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0887-6924 |
| ispartof | Leukemia, 2021-03, Vol.35 (3), p.809-822 |
| issn | 0887-6924 1476-5551 |
| language | eng |
| recordid | cdi_gale_infotracmisc_A655716379 |
| source | MEDLINE; SpringerLink Journals |
| subjects | 692/308/2171 692/308/2779/777 692/699/1541/1990/804 Adult Age Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols - therapeutic use Autografts Bortezomib Bortezomib - administration & dosage Cancer Research Consolidation Consolidation Chemotherapy - mortality Critical Care Medicine Development and progression Dose-response relationship (Biochemistry) Drug therapy Female Follow-Up Studies Hematology Hematopoietic stem cells Humans Immunotherapy Induction Chemotherapy - mortality Induction therapy Inhibitor drugs Intensive Internal Medicine Lenalidomide - administration & dosage Maintenance Male Medicine Medicine & Public Health Melphalan Middle Aged Multiple myeloma Multiple Myeloma - drug therapy Multiple Myeloma - pathology Oncology Patient outcomes Prognosis Prospective Studies Stem cell transplantation Stem cells Survival Survival Rate Targeted cancer therapy Therapy Toxicity Transplantation Transplants & implants |
| title | Bortezomib-based induction, high-dose melphalan and lenalidomide maintenance in myeloma up to 70 years of age |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-19T08%3A13%3A34IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Bortezomib-based%20induction,%20high-dose%20melphalan%20and%20lenalidomide%20maintenance%20in%20myeloma%20up%20to%2070%20years%20of%20age&rft.jtitle=Leukemia&rft.au=Mai,%20Elias%20K.&rft.aucorp=German-speaking%20Myeloma%20Multicenter%20Group%20(GMMG)&rft.date=2021-03-01&rft.volume=35&rft.issue=3&rft.spage=809&rft.epage=822&rft.pages=809-822&rft.issn=0887-6924&rft.eissn=1476-5551&rft_id=info:doi/10.1038/s41375-020-0976-9&rft_dat=%3Cgale_pubme%3EA655716379%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2496262756&rft_id=info:pmid/32684633&rft_galeid=A655716379&rfr_iscdi=true |