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.

@article{Palumbo2010Bortezomibmelphalanprednisonethali,
  title={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.},
  author={A. Palumbo and S. Bringhen and D. Rossi and M. Cavalli and A. Larocca and R. Ria and M. Offidani and F. Patriarca and C. Nozzoli and T. Guglielmelli and G. Benevolo and V. Callea and L. Baldini and F. Morabito and M. Grasso and G. Leonardi and M. Rizzo and A. Falcone and D. Gottardi and V. Montefusco and P. Musto and M. Petrucci and G. Ciccone and M. Boccadoro},
  journal={Journal of clinical oncology : official journal of the American Society of Clinical Oncology},
  year={2010},
  volume={28 34},
  pages={
          5101-9
        }
}
PURPOSE The combination of bortezomib-melphalan-prednisone (VMP) is a new standard of care for newly diagnosed multiple myeloma. This phase III study examined the efficacy of the four-drug combination of bortezomib-melphalan-prednisone-thalidomide (VMPT) followed by maintenance with bortezomib-thalidomide (VMPT-VT) compared with VMP treatment alone in untreated multiple myeloma patients who are ineligible for autologous stem-cell transplantation. PATIENTS AND METHODS A total of 511 patients… Expand
Bortezomib-melphalan-prednisone-thalidomide followed by maintenance with bortezomib-thalidomide compared with bortezomib-melphalan-prednisone for initial treatment of multiple myeloma: updated follow-up and improved survival.
  • A. Palumbo, S. Bringhen, +27 authors M. Cavo
  • Medicine
  • Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2014
TLDR
Bortezomib and thalidomide significantly improved OS in multiple myeloma patients not eligible for transplantation and were significantly more frequent in the VMPT-VT patients. Expand
Safety and efficacy of bortezomib-melphalan-prednisone-thalidomide followed by bortezomib-thalidomide maintenance (VMPT-VT) versus bortezomib-melphalan-prednisone (VMP) in untreated multiple myeloma patients with renal impairment.
TLDR
VMPT-VT was superior to VMP for cases with normal renal function and moderate RI, whereas VMPT -VT failed to outperform VMP in patients with severe RI, although the relatively low number of cases analyzed preclude drawing definitive conclusions. Expand
First-line therapy with either bortezomib-melphalan-prednisone or lenalidomide-dexamethasone followed by lenalidomide for transplant-ineligible multiple myeloma patients: a pooled analysis of two randomized trials
TLDR
In this non-randomized analysis, VMP and Rd-R were equally effective in younger (≤75 years), standard-risk patients, while older ones (>75 years) benefited more from Rd- R and in high- risk patients, V MP improved progression-free survival and overall survival irrespective of age. Expand
Maintenance therapy with bortezomib plus thalidomide or bortezomib plus prednisone in elderly multiple myeloma patients included in the GEM2005MAS65 trial.
TLDR
These maintenance regimens result in a significant increase in CR rate, remarkably long PFS, and acceptable toxicity profile, and this approach was not able to overcome the adverse prognosis of cytogenetic abnormalities. Expand
Bortezomib, melphalan, prednisone (VMP) versus melphalan, prednisone, thalidomide (MPT) in elderly newly diagnosed multiple myeloma patients: A retrospective case‐matched study
TLDR
Multivariate analysis confirmed that VMP was an independent predictor of longer PFS and OS in patients who received VMP in comparison with those treated with MPT. Expand
The effects of different schedules of bortezomib, melphalan, and prednisone for patients with newly diagnosed multiple myeloma who are transplant ineligible: a matching-adjusted indirect comparison
TLDR
Findings support a modified VMP dosing schedule for patients with NDMM who are transplant ineligible, which demonstrated superior efficacy based on the VISTA trial and significantly reduced peripheral neuropathy. Expand
Sequential therapy of four cycles of bortezomib, melphalan, and prednisolone followed by continuous lenalidomide and dexamethasone for transplant-ineligible newly diagnosed multiple myeloma
TLDR
Se sequential therapy with VMP followed by Rd is effective and mostly feasible for transplant-ineligible NDMM. Expand
Comparative Efficacy of Bortezomib, Melphalan, and Prednisone (VMP) With or Without Daratumumab Versus VMP Alone in the Treatment of Newly Diagnosed Multiple Myeloma: Propensity Score Matching of ALCYONE and VISTA Phase III Studies.
TLDR
This propensity score matching analysis demonstrates significant improvements in efficacy with ALCYONE D-VMP versus VISTA VMP and a significantly lower incidence of peripheral sensory neuropathy in both arms of ALCyONE versus VISta VMP, although safety improvements may be due to different bortezomib administration routes. Expand
Outcomes with two different schedules of bortezomib, melphalan, and prednisone (VMP) for previously untreated multiple myeloma: matched pair analysis using long-term follow-up data from the phase 3 VISTA and PETHEMA/GEM05 trials
TLDR
It is suggested that the less-intensive PETHEMA/GEM05 VMP regimen plus maintenance may improve PFS and TTP, but not OS, compared with the VISTA V MP regimen. Expand
Superiority of the triple combination of bortezomib-thalidomide-dexamethasone over the dual combination of thalidomide-dexamethasone in patients with multiple myeloma progressing or relapsing after autologous transplantation: the MMVAR/IFM 2005-04 Randomized Phase III Trial from the Chronic Leukemia
TLDR
VTD was more effective than TD in the treatment of patients with MM with progressive or relapsing disease post-ASCT but was associated with a higher incidence of grade 3 neurotoxicity. Expand
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References

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A Prospective, Multicenter, Randomized, Trial of Bortezomib/Melphalan/Prednisone (VMP) Versus Bortezomib/Thalidomide/Prednisone (VTP) as Induction Therapy Followed by Maintenance Treatment with Bortezomib/Thalidomide (VT) Versus Bortezomib/Prednisone (VP) in Elderly Untreated Patients with Multiple
TLDR
The intensity of both schedules of induction was reduced as compared with the VISTA regimen but supplemented with maintenance therapy, and maintenance therapy was able to increase the CR rate from 25% (mean obtained after induction therapy) up to 42%, with no significant differences between VT and VP arms. Expand
Bortezomib, melphalan, prednisone, and thalidomide for relapsed multiple myeloma.
TLDR
Initial results showed that VMPT is an effective salvage therapy with a very high proportion of responses and the incidence of neurotoxicities was unexpectedly low. Expand
Oral melphalan and prednisone chemotherapy plus thalidomide compared with melphalan and prednisone alone in elderly patients with multiple myeloma: randomised controlled trial
TLDR
Oral MPT is an effective first-line treatment for elderly patients with multiple myeloma and anticoagulant prophylaxis reduces frequency of thrombosis. Expand
Consolidation therapy with low-dose thalidomide and prednisolone prolongs the survival of multiple myeloma patients undergoing a single autologous stem-cell transplantation procedure.
TLDR
Consolidation therapy with 12 months of thalidomide combined with prednisolone prolongs survival when used after a single high-dose therapy supported ASCT in patients with newly diagnosed multiple myeloma. Expand
Melphalan and prednisone plus thalidomide versus melphalan and prednisone alone or reduced-intensity autologous stem cell transplantation in elderly patients with multiple myeloma (IFM 99–06): a randomised trial
TLDR
The results of this trial provide strong evidence to indicate that the use of thalidomide in combination with melphalan and prednisone should, at present, be the reference treatment for previously untreated elderly patients with multiple myeloma. Expand
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TLDR
Bortezomib plus melphalan-prednisone alone in patients with newly diagnosed myeloma who were ineligible for high-dose therapy was superior to melphAlan-predisonsone alone. Expand
Melphalan + Prednisone Versus Melphalan + Prednisone + Thalidomide in Induction Therapy for Multiple Myeloma in Elderly Patients: Final Analysis of the Dutch Cooperative Group HOVON 49 Study
TLDR
In this randomised phase III study in elderly patients with multiple myeloma the addition of Thalidomide to MP resulted in a significant better RR and the quality of the responses (number of VGPR and PFS after CR/PR) and time to response were in favour of MPT. Expand
Efficacy of melphalan and prednisone plus thalidomide in patients older than 75 years with newly diagnosed multiple myeloma: IFM 01/01 trial.
  • C. Hulin, T. Facon, +17 authors P. Moreau
  • Medicine
  • Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2009
TLDR
This trial confirms the superiority of the combination melphalan and prednisone plus thalidomide over melphAlan andprednisone alone for prolonging survival in very elderly patients with newly diagnosed myeloma. Expand
Melphalan, prednisone, and lenalidomide treatment for newly diagnosed myeloma: a report from the GIMEMA--Italian Multiple Myeloma Network.
  • A. Palumbo, P. Falco, +15 authors M. Petrucci
  • Medicine
  • Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2007
TLDR
Oral MPR therapy is a promising first-line treatment for elderly myeloma patients and aspirin appears to provide adequate antithrombosis prophylaxis. Expand
A Phase III Study to Determine the Efficacy and Safety of Lenalidomide in Combination with Melphalan and Prednisone (MPR) in Elderly Patients with Newly Diagnosed Multiple Myeloma
TLDR
PFS was significantly improved in patients who received MPR followed by lenalidomide maintenance compared with those who received MP followed by placebo maintenance, demonstrating a highly statistically significant improvement in PFS for patients treated with MPR compared with MP as first-line treatment for MM patients. Expand
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