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Morgan GJ, Walker BA, Davies FE. The genetic architecture of multiple myeloma. Nat Rev Cancer. 2012;12:335-48. This paper reports an interesting theory: myeloma is a heterogeneous disease characterized by different sub-clones that determine the disease course and the possible response to drugs.
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Part II: Role of maintenance therapy in transplant-ineligible patients
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Palumbo A, Bringhen S, Ludwig H, et al. Personalized therapy in multiple myeloma according to patient age and vulnerability: a report of European Myeloma Network (EMN). Blood. 2011;118:4519-29. An important and recent EMN report on frail patients.
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Bortezomib as induction before autologous transplantation, followed by lenalidomide as consolidation-maintenance in untreated multiple myeloma patients
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Prospective randomized trial of Len/Dex induction followed by tandem Mel 140 with autologous blood stem cell transplantation and Len maintenance versus continued therapy with Len/Dex in myeloma patients age 60-75 years: Protocol-defined safety analysis after 100 patients
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Atlanta, Georgia; December 8-11
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Palumbo A, Bringhen S, Caravita T, et al. Oral melphalan and prednisone chemotherapy plus thalidomide compared with melphalan and prednisone alone in elderly patients with multiple myeloma: randomized controlled trial. Lancet. 2006;367:825-31.
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Oral melphalan, prednisone, and thalidomide in elderly patients with multiple myeloma: Updated results of a randomized controlled trial
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Phase III study of the value of thalidomide added to melphalan plus prednisone in elderly patients with newly diagnosed multiple myeloma: The HOVON 49 Study
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Wijermans P, Schaafsma M, Termorshuizen F, et al. Phase III study of the value of thalidomide added to melphalan plus prednisone in elderly patients with newly diagnosed multiple myeloma: the HOVON 49 Study. J Clin Oncol. 2010;28:3160-6.
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Hulin C, Facon T, Rodon P, et al. Efficacy of melphalan and prednisone plus thalidomide in patients older than 75 years with newly diagnosed multiple myeloma: IFM 01/01 trial. J Clin Oncol. 2009;27:64-70.
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21670471 10.1182/blood-2011-03-341669 1:CAS:528:DC%2BC3MXhtVCnurvF An interesting meta-analysis combining patient data from 6 randomized trials with MPT
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Fayers PM, Palumbo A, Hulin C, et al. Thalidomide for previously untreated elderly patients with multiple myeloma: meta-analysis of 1685 individual patient data from 6 randomized clinical trials. Blood. 2011;118:1239-47. An interesting meta-analysis combining patient data from 6 randomized trials with MPT.
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Blood
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Fayers, P.M.1
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Safety of thalidomide in newly diagnosed elderly myeloma patients: A meta-analysis of data from individual patients in six randomized trials
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Palumbo A, Waage A, Hulin C, et al. Safety of thalidomide in newly diagnosed elderly myeloma patients: a meta-analysis of data from individual patients in six randomized trials. Haematologica. 2013;98:87-94.
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26
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Cyclophosphamide, thalidomide, and dexamethasone (CTD) as initial therapy for patients with multiple myeloma unsuitable for autologous transplantation
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Morgan GJ, Davies FE, Gregory WM, et al. Cyclophosphamide, thalidomide, and dexamethasone (CTD) as initial therapy for patients with multiple myeloma unsuitable for autologous transplantation. Blood. 2011;118:1231-8.
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23233713 10.1200/JCO.2012.41.6180 1:CAS:528:DC%2BC3sXis1Sktbo%3D A recent update of the VISTA study confirming the benefit of VMP over MP
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San Miguel JF, Schlag R, Khuageva NK, et al. Persistent overall survival benefit and no increased risk of second malignancies with bortezomib-melphalan- prednisone versus melphalan-prednisone in patients with previously untreated myeloma. J Clin Oncol. 2013;31:448-55. A recent update of the VISTA study confirming the benefit of VMP over MP.
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J Clin Oncol
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San Miguel, J.F.1
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Bortezomib, melphalan, and prednisone versus bortezomib, thalidomide, and prednisone as induction therapy followed by maintenance treatment with bortezomib and thalidomide versus bortezomib and prednisone in elderly patients with untreated multiple myeloma: A randomised trial
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Mateos MV, Oriol A, Martínez-López J, et al. Bortezomib, melphalan, and prednisone versus bortezomib, thalidomide, and prednisone as induction therapy followed by maintenance treatment with bortezomib and thalidomide versus bortezomib and prednisone in elderly patients with untreated multiple myeloma: a randomised trial. Lancet Oncol. 2010;11:934-41.
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Bortezomib-melphalan-prednisone-thalidomide followed by maintenance with bortezomib-thalidomide compared with bortezomib-melphalan-prednisone for initial treatment of multiple myeloma: A randomized controlled trial
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20940200 10.1200/JCO.2010.29.8216 1:CAS:528:DC%2BC3MXltlKnsw%3D%3D
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Palumbo A, Bringhen S, Rossi D, et al. Bortezomib-melphalan-prednisone- thalidomide followed by maintenance with bortezomib-thalidomide compared with bortezomib-melphalan-prednisone for initial treatment of multiple myeloma: a randomized controlled trial. J Clin Oncol. 2010;28:5101-9.
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Overall survival benefit for bortezomib-melphalan-prednisone-thalidomide followed by maintenance with bortezomib-thalidomide (VMPT-VT) versus bortezomib-melphalan-prednisone (VMP) in newly diagnosed multiple myeloma patients
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Atlanta, Georgia; December 8-11
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Palumbo A, Bringhen S, Rossi D, et al. Overall survival benefit for bortezomib-melphalan-prednisone-thalidomide followed by maintenance with bortezomib-thalidomide (VMPT-VT) versus bortezomib-melphalan-prednisone (VMP) in newly diagnosed multiple myeloma patients. Abstract presented at the 54th American Society of Hematology conference. Atlanta, Georgia; December 8-11, 2012. The study with the highest rate of CR. Median overall survival was not reached yet, and it may be quite high.
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54th American Society of Hematology Conference
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Falco P, Cavallo F, Larocca A, et al. Lenalidomide-prednisone induction followed by lenalidomide-melphalan-prednisone consolidation and lenalidomide-prednisone maintenance in newly diagnosed elderly unfit myeloma patients. Leukemia. 2013;27:695-701.
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Continuous lenalidomide treatment for newly diagnosed multiple myeloma
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10.1056/NEJMoa1112704 A recent study confirming the benefit of lenalidomide maintenance after MPR treatment
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Palumbo A, Hajek R, Delforge M, et al. Continuous lenalidomide treatment for newly diagnosed multiple myeloma. N Engl J Med. 2012;336:1759-69. A recent study confirming the benefit of lenalidomide maintenance after MPR treatment.
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N Engl J Med
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Palumbo, A.1
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Rajkumar SV, Jacobus S, Callander NS, et al. Lenalidomide plus high-dose dexamethasone versus lenalidomide plus low-dose dexamethasone as initial therapy for newly diagnosed multiple myeloma: an open-label randomised controlled trial. Lancet Oncol. 2010;11:29-37.
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