Blood：药物组合疗法有助治疗多发性骨髓瘤

三种药物治疗为一种血癌类型--多发性骨髓瘤提供了快速，深刻的和潜在的持久的反应，研究人员将最新研究论文发表在Blood杂志上。

芝加哥大学医学中心的主任医师Andrzej J. Jakubowiak博士带领研究人员发现相比原于一线治疗方案，carfilzomib（新一代蛋白酶抑制剂）联合lenalidomide和低剂量地塞米松治疗多发性骨髓瘤效果更好。

Jakubowiak说：这些迅速和持久的药物应答反应明显优于目前治疗多发性骨髓瘤的既定方案。 参加该研究小组的有四个临床中心的53名患者。患者年龄在35至81岁之间，都是刚被新诊断为患有多发性骨髓瘤。每个病人给予所有三种药物，carfilzomib剂量水平被提高两倍。这些药物组合基本能对多数病人起到迅速疗效，并疗效较持久。Jakubowiak说：初诊患者骨髓瘤是最敏感的治疗对象。（生物谷：Bioon.com）

doi:10.1182/blood-2012-04-422683
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A phase 1/2 study of carfilzomib in combination with lenalidomide and low-dose dexamethasone as a frontline treatment for multiple myeloma

Andrzej J. Jakubowiak,*, Dominik Dytfeld, Kent A. Griffith, Daniel Lebovic, David H. Vesole, Sundar Jagannath, Ammar Al-Zoubi, Tara Anderson, et al.

This phase 1/2 study in patients with newly diagnosed multiple myeloma (N=53) assessed CRd—carfilzomib (20, 27, or 36 mg/m², days 1, 2, 8, 9, 15, 16 and 1, 2, 15, 16 after Cycle 8), lenalidomide (25 mg/day, days 1–21), and weekly dexamethasone (40/20 mg Cycles 1–4/5+)—in 28-day cycles. After Cycle 4, transplant-eligible candidates underwent stem cell collection (SCC) then continued CRd with the option of transplantation. The maximum planned dose level (carfilzomib 36 mg/m²) was expanded in phase 2 (n=36). Thirty-five patients underwent SCC, 7 proceeded to transplantation, and the remainder resumed CRd. Grade 3/4 toxicities included hypophosphatemia (25%), hyperglycemia (23%), anemia (21%), thrombocytopenia (17%), and neutropenia (17%); peripheral neuropathy was limited to Grade 1/2 (23%). Most patients did not require dose modifications. After a median of 12 cycles (range 1–25), 62% (N=53) achieved at least near complete response (nCR) and 42% stringent CR (sCR). Responses were rapid and improved during treatment. In 36 patients completing 8 or more cycles, 78% reached at least nCR and 61% sCR. With median follow-up of 13 months (range 4–25), 24-month progression-free survival estimate was 92%. CRd was well tolerated with exceptional response rates. Registered at www.clinicaltrials.