Abstract:
:Renal impairment is associated with poor prognosis in multiple myeloma (MM). This subgroup analysis of the phase 3 Assessment of Proteasome Inhibition for Extending Remissions (APEX) study of bortezomib vs high-dose dexamethasone assessed efficacy and safety in patients with relapsed MM with varying degrees of renal impairment (creatinine clearance (CrCl) <30, 30-50, 51-80 and >80 ml min(-1)). Time to progression (TTP), overall survival (OS) and safety were compared between subgroups with CrCl < or =50 ml min(-1) (severe-to-moderate) and >50 ml min(-1) (no/mild impairment). Response rates with bortezomib were similar (36-47%) and time to response rapid (0.7-1.6 months) across subgroups. Although the trend was toward shorter TTP/OS in bortezomib patients with severe-to-moderate vs no/mild impairment, differences were not significant. OS was significantly shorter in dexamethasone patients with CrCl < or =50 vs >50 ml min(-1) (P=0.003), indicating that bortezomib is more effective than dexamethasone in overcoming the detrimental effect of renal impairment. Safety profile of bortezomib was comparable between subgroups. With dexamethasone, grade 3/4 adverse events (AEs), serious AEs and discontinuations for AEs were significantly elevated in patients with CrCl < or =50 vs >50 ml min(-1). These results indicate that bortezomib is active and well tolerated in patients with relapsed MM with varying degrees of renal insufficiency. Efficacy/safety were not substantially affected by severe-to-moderate vs no/mild impairment.
journal_name
Leukemiajournal_title
Leukemiaauthors
San-Miguel JF,Richardson PG,Sonneveld P,Schuster MW,Irwin D,Stadtmauer EA,Facon T,Harousseau JL,Ben-Yehuda D,Lonial S,Goldschmidt H,Reece D,Bladé J,Boccadoro M,Cavenagh JD,Neuwirth R,Boral AL,Esseltine DL,Anderson KCdoi
10.1038/sj.leu.2405087subject
Has Abstractpub_date
2008-04-01 00:00:00pages
842-9issue
4eissn
0887-6924issn
1476-5551pii
2405087journal_volume
22pub_type
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