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首页> 外文期刊>British Journal of Haematology >Bortezomib-Cyclophosphamide-Dexamethasone (VCD) versus Bortezomib-Thalidomide-Dexamethasone (VTD) -based regimens as induction therapies in newly diagnosed transplant eligible patients with multiple myeloma: A meta-analysis
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Bortezomib-Cyclophosphamide-Dexamethasone (VCD) versus Bortezomib-Thalidomide-Dexamethasone (VTD) -based regimens as induction therapies in newly diagnosed transplant eligible patients with multiple myeloma: A meta-analysis

机译：硼替佐米-环磷酰胺-地塞米松（VCD）与以硼替佐米-沙利度胺-地塞米松（VTD）为基础的方案在新诊断为移植性多发性骨髓瘤患者中作为诱导疗法：荟萃分析

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Three-drug induction regimens have become the standard of care in newly diagnosed transplant-eligible multiple myeloma patients. Two frequently used protocols are bortezomib, cyclophosphamide and dexamethasone (VCD) and bortezomib, thalidomide and dexamethasone (VTD). Comparisons between the two are lacking. The present study aimed to identify the differences in response rate and toxicity between the two regimens. Databases were searched using the terms 'VTD' or 'VCD' and 'induction regimens for newly diagnosed multiple myeloma'. Prospective trials evaluating initial response in transplant eligible patients were included. The main outcome measures were response rates and adverse events. Eight clinical trials were eligible for analysis. Overall 672 patients were treated with either VCD (n = 157) or VTD (n = 515) as induction therapy. Patients treated with VTD presented with a significantly higher completeear complete response (34% vs. 6%, P = 0·002) as well as a higher very good partial response rate or better, following induction therapy (62% vs. 27%, P < 0·0001). Although grade 3-4 neurotoxicity was more frequent during VTD therapy (11% vs. 6%, P = 0·057), a higher incidence of overall grade 3-4 adverse events was found in the VCD-treated patients (74% vs. 51%, P < 0·001). VTD induction therapy may be superior in achieving deeper response rate following induction therapy, and is better tolerated.
机译：三药诱导方案已成为新诊断的适合移植的多发性骨髓瘤患者的治疗标准。两种常用的方案是硼替佐米，环磷酰胺和地塞米松（VCD）和硼替佐米，沙利度胺和地塞米松（VTD）。两者之间缺乏比较。本研究旨在确定两种方案之间反应率和毒性的差异。使用术语“ VTD”或“ VCD”和“新诊断的多发性骨髓瘤的诱导方案”搜索数据库。纳入评估移植合格患者初始反应的前瞻性试验。主要结局指标是缓解率和不良事件。八项临床试验符合分析条件。共有672例患者接受了VCD（n = 157）或VTD（n = 515）的诱导治疗。在诱导治疗后，接受VTD治疗的患者的完全/接近完全缓解率显着更高（34％比6％，P = 0·002）以及更高的非常好的部分缓解率（62％比27）。 ％，P <0·0001）。尽管在VTD治疗期间3-4级神经毒性更为频繁（11％比6％，P = 0·057），但VCD治疗的患者发生3-4级整体不良事件的发生率更高（74％vs 51％，P ＜0·001）。 VTD诱导疗法可能在诱导疗法后获得更深的缓解率方面具有优势，并且耐受性更好。

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