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01-10-2014 | Research

Modified Bortezomib, Adriamycin and Dexamethasone (PAD) Regimen in Advanced Multiple Myeloma

Authors: Yongqing Zhang, Hongjuan Liu, Xiequn Chen, Qingxian Bai, Rong Liang, Bing Shi, Lihui Liu, DengMei Tian, Mingjuan Liu

Published in: Pathology & Oncology Research | Issue 4/2014

Abstract

The PAD regime, composed of bortezomib, adriamycin and dexamethasone, improves the outcomes of patients with advanced multiple myeloma (MM), but at the same time produces high frequency of serious toxic side effects. For the first time, we evaluated the efficacy and safety of a bortezomib-dose-reduced PAD regime in the treatment of relapsed/refractory MM in this clinical study. Forty-five patients were treated with two to six 21-day cycles of PAD, comprising bortezomib at 1.3 mg/m² (P₁AD, n = 21) or 1.0 mg/m² (P₂AD, n = 24) (days 1, 4, 8, 11), adriamycin at 9 mg/m² (days 1–4) and dexamethasone at 40 mg/day (days 1–4). Overall, 36 patients (80 %) showed at least partial remission (PR), in which 9 cases (20 %) showed complete remission (CR) and 10 cases (22 %) showed very good partial remission (VGPR). The efficacy of PAD regimen in advanced MM patients was not related to the traditional prognostic factors. There was no significant difference between P₁AD and P₂AD in the rates of PR, CR or VGPR, 1.5-year progression-free survival (PFS), and overall survival (OS) (81 % vs. 79 %, 48 % vs. 38 %, 64 % vs. 59 %, and 85 % vs. 73 %, respectively). However, the grade 3–4 toxic effects, including thrombocytopenia (13 % vs. 38 %), peripheral neuropathy (8 % vs. 33 %) and 3–4 grade gastrointestinal reaction (13 % vs. 43 %), were markedly inhibited after P₂AD compared to P₁AD (P < 0.05). The bortezomib-dose-reduced PAD regime reduced the incidence of adverse reactions without affecting the treatment efficacy in patients with advanced MM.

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Title: Modified Bortezomib, Adriamycin and Dexamethasone (PAD) Regimen in Advanced Multiple Myeloma
Authors: Yongqing Zhang
Hongjuan Liu
Xiequn Chen
Qingxian Bai
Rong Liang
Bing Shi
Lihui Liu
DengMei Tian
Mingjuan Liu
Publication date: 01-10-2014
Publisher: Springer Netherlands
Published in: Pathology & Oncology Research / Issue 4/2014
Print ISSN: 1219-4956
Electronic ISSN: 1532-2807
DOI: https://doi.org/10.1007/s12253-014-9785-7

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