Document Detail


Integrating novel therapies in the transplant paradigm.
MedLine Citation:
PMID:  20010167     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The introduction of novel therapies (thalidomide, bortezomib, and lenalidomide) is changing the management of multiple myeloma in younger patients who are usually candidates for autologous stem cell transplantation (ASCT). Randomized trials have shown the superiority of induction treatment with novel agents compared with the classic VAD regimen. Complete remission plus very good partial remission rates of 40% to 60% after induction and of 60% to 75% are achieved with bortezomib-dexamethasone or with 3-drug combinations (including 1 or 2 novel agents). Six randomized studies have evaluated the impact of thalidomide as post-ASCT maintenance therapy. Despite differences in the design of the studies and in thalidomide administration, all 6 studies show a significant benefit in the thalidomide arm in terms of response rate and progression-free survival. Results are not as clear in terms of survival. The addition of novel agents before and after ASCT yields very high complete remission and promising progression-free survival rates. On the other hand, results obtained with novel agents are attractive as well and randomized studies comparing novel agents plus early ASCT versus novel agents plus ASCT at progression are planned.
Authors:
Jean-Luc Harousseau
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Cancer journal (Sudbury, Mass.)     Volume:  15     ISSN:  1540-336X     ISO Abbreviation:  Cancer J     Publication Date:    2009 Nov-Dec
Date Detail:
Created Date:  2009-12-16     Completed Date:  2011-01-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100931981     Medline TA:  Cancer J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  479-84     Citation Subset:  IM    
Affiliation:
Cancer Center René Gauducheau, Bd J Monod, 44805 Nantes Saint Herblain, France. jl-harousseau@nantes.fnclcc.fr
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MeSH Terms
Descriptor/Qualifier:
Angiogenesis Inhibitors / administration & dosage
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Boronic Acids / administration & dosage
Dexamethasone / administration & dosage
Disease Progression
Drug Therapy, Combination
Humans
Multiple Myeloma / drug therapy,  mortality,  therapy*
Protease Inhibitors / administration & dosage
Pyrazines / administration & dosage
Stem Cell Transplantation*
Thalidomide / administration & dosage,  analogs & derivatives
Transplantation, Autologous
Chemical
Reg. No./Substance:
0/Angiogenesis Inhibitors; 0/Boronic Acids; 0/Protease Inhibitors; 0/Pyrazines; 0/bortezomib; 191732-72-6/lenalidomide; 50-02-2/Dexamethasone; 50-35-1/Thalidomide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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