Impact of induction treatment before autologous stem cell transplantation on long term outcome in patients with newly diagnosed multiple myeloma.
Eur J Haematol. 2017 Feb 16;:
Authors: Gassiot S, Motlló C, Llombart I, Morgades M, González Y, Garcia-Caro M, Ribera JM, Oriol A
OBJECTIVE: Clinical trials for multiple myeloma patients using novel agent-based regimens before autologous stem cell transplantation (SCT) have shown improvement in response rates and progression-free survival (PFS), however they have failed to identify a significant overall survival (OS) benefit. The aim of this study was to analyze the potential impact of initial induction on the feasibility and outcome of subsequent treatment lines in a real clinical practice setting.
METHODS: Consecutive multiple myeloma patients less than 70 years of age diagnosed between 1999 and 2009 were prospectively registered and classified as having received conventional chemotherapy induction regimens with new agents available at relapse (CC cohort, 89 patients) or as treated with novel agents upfront (NA cohort, 65 patients).
RESULTS: Patients in the NA cohort demonstrated a superior median PFS (2.8 years vs. 1.6 years, P=0.03) and also a median PFS from diagnosis to second progression (5.2 years vs. 2.7 years, P=0.003). After a median follow-up of 7 years, clear differences in OS were observed (7.97 years in NA cohort compared to 3.35 years in CC cohort, P<001).
CONCLUSIONS: New agent based first-line induction treatments provide benefits both in PFS and beyond that point, contributing to a significant improvement in OS. This article is protected by copyright. All rights reserved.
PMID: 28208219 [PubMed - as supplied by publisher]
Nanoparticle delivery systems, general approaches and their implementation in Multiple Myeloma.
Eur J Haematol. 2017 Feb 16;:
Authors: de la Puente P, Azab AK
Multiple myeloma (MM) is a hematological malignancy that remains incurable, with relapse rates greater than 90%. The main limiting factor for the effective use of chemotherapies in MM is the serious side effects caused by these drugs. The emphasis in cancer treatment has shifted from cytotoxic, non-specific chemotherapies to molecularly targeted and rationally designed therapies showing greater efficacy and fewer side effects. Traditional chemotherapy has shown several disadvantages such as lack of targeting capabilities, systemic toxicity and side effects; low therapeutic index, as well as, most anticancer drugs have poor water solubility. Nanoparticle delivery systems (NPs) are capable of targeting large doses of chemotherapies into the target area while sparing healthy tissues, overcoming the limitations of traditional chemotherapy. Here, we review the current state-of-the-art in nanoparticle-based strategies designed to treat multiple myeloma. Many nanoparticle delivery systems have been studied for myeloma using non-targeted NPs (liposomes, polymeric NPs, and inorganic NPs), triggered NPs, as well as targeted NPs (VLA-4, ABC drug transporters, bone microenvironment targeting). The results in preclinical and clinical studies are promising; however, there remains much to be learned in the emerging field of nanomedicine in myeloma. This article is protected by copyright. All rights reserved.
PMID: 28208215 [PubMed - as supplied by publisher]