Salvage Therapy Under Study for Resistant Myeloma With Extramedullary Disease
Posted: Tuesday, October 13, 2020
Salvage therapy with the regimen VD-PACE—bortezomib, dexamethasone, platinum, doxorubicin, cyclophosphamide, etoposide—plus an immunomodulatory agent may potentially achieve a significant response for patients with relapsed or refractory multiple myeloma who have extramedullary disease, according to findings presented during the 2020 Society of Hematologic Oncology (SOHO) Annual Meeting (Abstract MM-234). The combination salvage therapy for the plasmacytoma disease demonstrated high overall response rates and manageable adverse events, reported Siddhartha Ganguly, MD, of the Carolinas Healthcare System, Charlotte, and colleagues.
“We believe this treatment followed by high-dose chemotherapy with autologous stem cell transplant should be encouraged if the patient is eligible for transplant,” the authors concluded.
In this study, the authors treated 17 patients with relapsed or refractory multiple myeloma who had extramedullary disease in the University of Kansas Health System from January 2012 to January 2018. The patients were treated with VD-PACE salvage therapy plus an immunomodulatory agent. The median age of patients was 61 years.
The overall response rate reported was 71%, the complete response rate was 12%, the very good partial response or better rate was 35%, the partial response rate was 29%, and 12% had stable disease. Of the 17 patients, 14 proceeded with autologous stem cell transplantation and/or allogeneic stem cell transplant (82%). Three patients received other regimen-based therapies (18%).
The median progression-free survival was 9.44 months, with overall survival of 14.9 months. The most common grade 3 or more events were thrombocytopenia (94%), neutropenia (94%), and anemia (88%), as well as febrile neutropenia (35%). According to the study authors, all adverse events were “manageable.”
Disclosure: No disclosure information was provided for the study authors.