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Article Dans Une Revue Journal of clinical oncology . official journal of the American Society of Clinical Oncology Année : 2020

Bortezomib, melphalan, and dexamethasone for light-chain amyloidosis

Maria Teresa Cibeira
  • Fonction : Auteur
Arnaud Jaccard
  • Fonction : Auteur
Bradley Augustson
  • Fonction : Auteur
Ashutosh Wechalekar
  • Fonction : Auteur
Paolo Milani
  • Fonction : Auteur
Andrea Foli
  • Fonction : Auteur
Catherine Klersy
  • Fonction : Auteur

Résumé

Oral melphalan and dexamethasone (MDex) were considered a standard of care in light-chain (AL) amyloidosis. In the past decade, bortezomib has been increasingly used in combination with alkylating agents and dexamethasone. We prospectively compared the efficacy and safety of MDex and MDex with the addition of bortezomib (BMDex). This was a phase III, multicenter, randomized, open-label trial. Patients were stratified according to cardiac stage. Patients with advanced cardiac stage (stage IIIb) amyloidosis were not eligible. The primary end point was hematologic response rate at 3 months. This trial is registered with ClinicalTrials.gov identifier NCT01277016. A total of 109 patients, 53 in the BMDex and 56 in the MDex group, received ≥ 1 dose of therapy (from January 2011 to February 2016). Hematologic response rate at 3 months was higher in the BMDex arm (79% vPv BMDex improved hematologic response rate and overall survival. To our knowledge, this is the first time a controlled study has demonstrated a survival advantage in AL amyloidosis. BMDex should be considered a new standard of care for AL amyloidosis.

Dates et versions

hal-04523366 , version 1 (27-03-2024)

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Citer

Efstathios Kastritis, Xavier Leleu, Bertrand Arnulf, Elena Zamagni, Maria Teresa Cibeira, et al.. Bortezomib, melphalan, and dexamethasone for light-chain amyloidosis. Journal of clinical oncology official journal of the American Society of Clinical Oncology, 2020, Journal of clinical oncology official journal of the American Society of Clinical Oncology, pp.JCO2001285. ⟨10.1200/JCO.20.01285⟩. ⟨hal-04523366⟩

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