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Garderet L, Iacobelli S, Moreau P, Dib M, Lafon I, Niederwieser D, Masszi T, Fontan J, Michallet M, Gratwohl A, Milone G, Doyen C, Pegourie B, Hajek R, Casassus P, Kolb B, Chaleteix C, Hertenstein B, Onida F, Ludwig H, Ketterer N, Koenecke C, van Os M, Mohty M, Cakana A, Gorin NC, de Witte T, Harousseau JL, Morris C, Gahrton G. 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 Working Party of the European Group for Blood and Marrow Transplantation. J Clin Oncol 2012; 30:2475-82. [DOI: 10.1200/jco.2011.37.4918] [Citation(s) in RCA: 165] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose This prospective multicenter phase III study compared the efficacy and safety of a triple combination (bortezomib-thalidomide-dexamethasone [VTD]) versus a dual combination (thalidomide-dexamethasone [TD]) in patients with multiple myeloma (MM) progressing or relapsing after autologous stem-cell transplantation (ASCT). Patients and Methods Overall, 269 patients were randomly assigned to receive bortezomib (1.3 mg/m2 intravenous bolus) or no bortezomib for 1 year, in combination with thalidomide (200 mg per day orally) and dexamethasone (40 mg orally once a day on 4 days once every 3 weeks). Bortezomib was administered on days 1, 4, 8, and 11 with a 10-day rest period (day 12 to day 21) for eight cycles (6 months), and then on days 1, 8, 15, and 22 with a 20-day rest period (day 23 to day 42) for four cycles (6 months). Results Median time to progression (primary end point) was significantly longer with VTD than TD (19.5 v 13.8 months; hazard ratio, 0.59; 95% CI, 0.44 to 0.80; P = .001), the complete response plus near-complete response rate was higher (45% v 21%; P = .001), and the median duration of response was longer (17.9 v 13.4 months; P = .04). The 24-month survival rate was in favor of VTD (71% v 65%; P = .093). Grade 3 peripheral neuropathy was more frequent with VTD (29% v 12%; P = .001) as were the rates of grades 3 and 4 infection and thrombocytopenia. Conclusion 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.
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Affiliation(s)
- Laurent Garderet
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Simona Iacobelli
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Philippe Moreau
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Mamoun Dib
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Ingrid Lafon
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Dietger Niederwieser
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Tamas Masszi
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Jean Fontan
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Mauricette Michallet
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Alois Gratwohl
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Giuseppe Milone
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Chantal Doyen
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Brigitte Pegourie
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Roman Hajek
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Philippe Casassus
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Brigitte Kolb
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Carine Chaleteix
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Bernd Hertenstein
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Francesco Onida
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Heinz Ludwig
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Nicolas Ketterer
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Christian Koenecke
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Marleen van Os
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Mohamad Mohty
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Andrew Cakana
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Norbert Claude Gorin
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Theo de Witte
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Jean Luc Harousseau
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Curly Morris
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
| | - Gösta Gahrton
- Laurent Garderet and Norbert Claude Gorin, University Hospital Saint-Antoine, Paris; Philippe Moreau, Mohamad Mohty, and Jean Luc Harousseau, University Hospital Nantes, Nantes; Mamoun Dib, University Hospital Angers, Angers; Ingrid Lafon, University Hospital Dijon, Dijon; Jean Fontan, University Hospital Besançon, Besançon; Mauricette Michallet, University Hospital Lyon, Lyon; Brigitte Pegourie, University Hospital Grenoble, Grenoble; Philippe Casassus, University Hospital Bobigny, Bobigny; Brigitte
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