Scientific Publications Database

Article Title: Cyclophosphamide-bortezomib-dexamethasone compared with bortezomib-dexamethasone in transplantation-eligible patients with newly diagnosed multiple myeloma
Authors: Figueiredo, A.; Atkins, H.; Mallick, R.; Kekre, N.; Kew, A.; McCurdy, A.
Journal: CURRENT ONCOLOGY Volume 27 Issue 2
Date of Publication:2020
Abstract:
Introduction Cyclophosphamide-bortezomib-dexamethasone (CyBorD) is considered a standard induction regimen for transplant-eligible patients with newly diagnosed multiple myeloma (MM). It has not been prospectively compared with bortezomib-dexamethasone (Bor-Dex). We aimed to compare the efficacy of CyBorD and Bor-Dex induction in transplant-eligible patients.Methods In a retrospective observational study at a single tertiary centre, all patients with transplant-eligible ivim who received induction with CyBorD or Bor-Dex between March 2008 and April 2016 were enrolled. Progression-free survival (PFs), response, and stem-cell collection for a first autologous stem-cell transplantation (aHscrr) were compared.Results Of 155 patients enrolled, 78 (50.3%) had received CyBorD, and 77 (49.7%), Bor-Dex. The patients in the Bor-Dex cohort were younger than those in the CyBorD cohort (median: 57 years vs. 62 years; p = 0.0002) and more likely to have had treatment held, reduced, or discontinued (26% vs. 14.5%, p = 0.11). The stem-cell mobilization regimen for both cohorts was predominantly cyclophosphamide and granulocyte colony-stimulating factor (GcsF). Plerixafor was used more often for the CyBorD cohort (p = 0.009), and more collection failures occurred in the CyBorD cohort (p = 0.08). In patients receiving Bor-Dex, more cells were collected (9.9x10(6) cells /kg vs. 7.7x10(6) cells /kg, p = 0.007). At day +100, a very good partial response or better was achieved in 75% of the CyBorD cohort and in 73% of the B or-D ex cohort (p = 0.77). Median PFS was 3.2 years in the B or-D ex cohort and 3.7 years in the CyBorD cohort (p = 0.56).Conclusions Overall efficacy was similar in our patients receiving CyBorD and Bor-Dex. After aliscT, no difference in depth of response or PFS was observed. Cyclophosphamide-GcsF seems to increase collection failures and hospitalizations in patients receiving CyBorD. Prospective studies are required to examine that relationship.