新疗法时代,蛋白酶体抑制剂联合治疗复发/难治性骨髓瘤的单日多化疗方案。

IF 2.3 3区 医学 Q2 HEMATOLOGY
Eric Wenlong Li, Esther Jones, Christian Bryant, Tracy King, Dipti Talaulikar, Jun Yen Ng, Adam Bryant, Zainab Ridha, Nicole Wong Doo, Anna Menzies, Silvia Ling, Shir Jing Ho, Edward Abadir, Vinay Vanguru, Douglas Joshua, P. Joy Ho
{"title":"新疗法时代,蛋白酶体抑制剂联合治疗复发/难治性骨髓瘤的单日多化疗方案。","authors":"Eric Wenlong Li,&nbsp;Esther Jones,&nbsp;Christian Bryant,&nbsp;Tracy King,&nbsp;Dipti Talaulikar,&nbsp;Jun Yen Ng,&nbsp;Adam Bryant,&nbsp;Zainab Ridha,&nbsp;Nicole Wong Doo,&nbsp;Anna Menzies,&nbsp;Silvia Ling,&nbsp;Shir Jing Ho,&nbsp;Edward Abadir,&nbsp;Vinay Vanguru,&nbsp;Douglas Joshua,&nbsp;P. Joy Ho","doi":"10.1111/ejh.14266","DOIUrl":null,"url":null,"abstract":"<p>PCAB (prednisone, cyclophosphamide, doxorubicin, carmustine) is a single-day regimen previously used for induction and now in relapsed/refractory multiple myeloma (RRMM). We retrospectively analysed the outcomes of 85 patients from five Australian centres. These included 30 patients (35.3%) who received PCAB with one additional agent (bortezomib most frequently). Median age of the patients was 65 years (37–80), with a median of four (1–8) prior lines of therapy. ORR was 37% (CR 4.9%). Median progression free survival and overall survival were 4.4 months (95% CI 3.5–6.7) and 7.4 months (95% CI 6.4–10.2), respectively. Extramedullary disease (EMD) was associated with shorter survival. Grade 3 or 4 cytopenia and febrile neutropenia occurred in 76.2% and 39.1%, respectively, with six (7.1%) treatment-related mortalities. Median inpatient stay was 3.3 days/28-day cycle (IQR 0.6–13), and for patients who died, a median of 20.2% of days alive were spent inpatient (IQR 6.4–39.1%). Three patients were successfully bridged to CAR T-cell therapy using PCAB, despite being penta-exposed and having EMD. PCAB may be considered as a useful salvage therapy amongst other polychemotherapy regimens in late relapse. Further studies is warranted to investigate and define its role as a bridging therapy to novel therapeutics.</p>","PeriodicalId":11955,"journal":{"name":"European Journal of Haematology","volume":"113 4","pages":"521-529"},"PeriodicalIF":2.3000,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ejh.14266","citationCount":"0","resultStr":"{\"title\":\"A single-day polychemotherapy regimen with proteasome inhibitor combinations for relapsed/refractory myeloma in the era of novel therapies\",\"authors\":\"Eric Wenlong Li,&nbsp;Esther Jones,&nbsp;Christian Bryant,&nbsp;Tracy King,&nbsp;Dipti Talaulikar,&nbsp;Jun Yen Ng,&nbsp;Adam Bryant,&nbsp;Zainab Ridha,&nbsp;Nicole Wong Doo,&nbsp;Anna Menzies,&nbsp;Silvia Ling,&nbsp;Shir Jing Ho,&nbsp;Edward Abadir,&nbsp;Vinay Vanguru,&nbsp;Douglas Joshua,&nbsp;P. Joy Ho\",\"doi\":\"10.1111/ejh.14266\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>PCAB (prednisone, cyclophosphamide, doxorubicin, carmustine) is a single-day regimen previously used for induction and now in relapsed/refractory multiple myeloma (RRMM). We retrospectively analysed the outcomes of 85 patients from five Australian centres. These included 30 patients (35.3%) who received PCAB with one additional agent (bortezomib most frequently). Median age of the patients was 65 years (37–80), with a median of four (1–8) prior lines of therapy. ORR was 37% (CR 4.9%). Median progression free survival and overall survival were 4.4 months (95% CI 3.5–6.7) and 7.4 months (95% CI 6.4–10.2), respectively. Extramedullary disease (EMD) was associated with shorter survival. Grade 3 or 4 cytopenia and febrile neutropenia occurred in 76.2% and 39.1%, respectively, with six (7.1%) treatment-related mortalities. Median inpatient stay was 3.3 days/28-day cycle (IQR 0.6–13), and for patients who died, a median of 20.2% of days alive were spent inpatient (IQR 6.4–39.1%). Three patients were successfully bridged to CAR T-cell therapy using PCAB, despite being penta-exposed and having EMD. PCAB may be considered as a useful salvage therapy amongst other polychemotherapy regimens in late relapse. Further studies is warranted to investigate and define its role as a bridging therapy to novel therapeutics.</p>\",\"PeriodicalId\":11955,\"journal\":{\"name\":\"European Journal of Haematology\",\"volume\":\"113 4\",\"pages\":\"521-529\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-07-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ejh.14266\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Haematology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/ejh.14266\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Haematology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ejh.14266","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

PCAB(泼尼松、环磷酰胺、多柔比星、卡莫司汀)是一种单日疗法,以前用于诱导治疗,现在用于复发/难治性多发性骨髓瘤(RRMM)。我们回顾性分析了来自澳大利亚五个中心的 85 名患者的治疗结果。其中有 30 名患者(35.3%)在接受 PCAB 治疗的同时还使用了一种额外的药物(最常用的是硼替佐米)。患者的中位年龄为 65 岁(37-80 岁),中位曾接受过四次(1-8 次)治疗。ORR为37%(CR为4.9%)。中位无进展生存期和总生存期分别为4.4个月(95% CI 3.5-6.7)和7.4个月(95% CI 6.4-10.2)。髓外疾病(EMD)与生存期缩短有关。3级或4级全血细胞减少症和发热性中性粒细胞减少症的发生率分别为76.2%和39.1%,治疗相关死亡率为6例(7.1%)。住院天数中位数为 3.3 天/28 天周期(IQR 0.6-13),死亡患者的住院天数中位数为 20.2%(IQR 6.4-39.1%)。有三位患者使用PCAB成功过渡到了CAR T细胞疗法,尽管他们已经暴露于五联征并患有EMD。在晚期复发的患者中,PCAB可被视为其他多化疗方案中一种有用的挽救疗法。我们有必要开展进一步的研究,探讨并确定PCAB作为新型疗法的桥接疗法的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

A single-day polychemotherapy regimen with proteasome inhibitor combinations for relapsed/refractory myeloma in the era of novel therapies

A single-day polychemotherapy regimen with proteasome inhibitor combinations for relapsed/refractory myeloma in the era of novel therapies

PCAB (prednisone, cyclophosphamide, doxorubicin, carmustine) is a single-day regimen previously used for induction and now in relapsed/refractory multiple myeloma (RRMM). We retrospectively analysed the outcomes of 85 patients from five Australian centres. These included 30 patients (35.3%) who received PCAB with one additional agent (bortezomib most frequently). Median age of the patients was 65 years (37–80), with a median of four (1–8) prior lines of therapy. ORR was 37% (CR 4.9%). Median progression free survival and overall survival were 4.4 months (95% CI 3.5–6.7) and 7.4 months (95% CI 6.4–10.2), respectively. Extramedullary disease (EMD) was associated with shorter survival. Grade 3 or 4 cytopenia and febrile neutropenia occurred in 76.2% and 39.1%, respectively, with six (7.1%) treatment-related mortalities. Median inpatient stay was 3.3 days/28-day cycle (IQR 0.6–13), and for patients who died, a median of 20.2% of days alive were spent inpatient (IQR 6.4–39.1%). Three patients were successfully bridged to CAR T-cell therapy using PCAB, despite being penta-exposed and having EMD. PCAB may be considered as a useful salvage therapy amongst other polychemotherapy regimens in late relapse. Further studies is warranted to investigate and define its role as a bridging therapy to novel therapeutics.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
5.50
自引率
0.00%
发文量
168
审稿时长
4-8 weeks
期刊介绍: European Journal of Haematology is an international journal for communication of basic and clinical research in haematology. The journal welcomes manuscripts on molecular, cellular and clinical research on diseases of the blood, vascular and lymphatic tissue, and on basic molecular and cellular research related to normal development and function of the blood, vascular and lymphatic tissue. The journal also welcomes reviews on clinical haematology and basic research, case reports, and clinical pictures.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信