Panobinostat plus bortezomib and dexamethasone in previously treated multiple myeloma: outcomes by prior treatment
- Authors
- Richardson, Paul G.; Hungria, Vania T. M.; Yoon, Sung-Soo; Beksac, Meral; Dimopoulos, Meletios Athanasios; Elghandour, Ashraf; Jedrzejczak, Wieslaw W.; Guenther, Andreas; Nakorn, Thanyaphong Na; Siritanaratkul, Noppadol; Schlossman, Robert L.; Hou, Jian; Moreau, Philippe; Lonial, Sagar; Lee, Jae Hoon; Einsele, Hermann; Sopala, Monika; Bengoudifa, Bourras-Rezki; Corrado, Claudia; Binlich, Florence; San-Miguel, Jesus F.
- Issue Date
- 11-Feb-2016
- Publisher
- AMER SOC HEMATOLOGY
- Citation
- BLOOD, v.127, no.6, pp.713 - 721
- Journal Title
- BLOOD
- Volume
- 127
- Number
- 6
- Start Page
- 713
- End Page
- 721
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/8572
- DOI
- 10.1182/blood-2015-09-665018
- ISSN
- 0006-4971
- Abstract
- Panobinostat is a potent pan-deacetylase inhibitor that affects the growth and survival of multiple myeloma (MM) cells through alteration of epigenetic mechanisms and protein metabolism. Panobinostat plus bortezomib and dexamethasone (PAN-BTZ-Dex) led to a significant increase in progression-free survival (PFS) vs placebo plus bortezomib and dexamethasone (Pbo-BTZ-Dex) in patients with relapsed or relapsed and refractory MM in the phase 3PANORAMA1 trial. This subgroup analysis evaluated outcomes in patients in the PANORAMA 1 trial based on prior treatment: a prior immunomodulatory drug (IMiD; n = 485), prior bortezomib plus an IMiD (n = 193), and >= 2 prior regimens including bortezomib and an IMiD (n = 147). Median PFS with PAN-BTZ-Dex vs Pbo-BTZ-Dex across subgroups was as follows: prior IMiD (12.3 vs 7.4 months; hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.43-0.68), prior bortezomib plus IMiD (10.6 vs 5.8 months; HR, 0.52; 95% CI, 0.36-0.76), and >= 2 prior regimens including bortezomib and an IMiD (12.5 vs 4.7 months; HR, 0.47; 95% CI, 0.31-0.72). Common grade 3/4 adverse events and laboratory abnormalities in patients who received PAN-BTZ-Dex across the prior treatment groups included thrombocytopenia, lymphopenia, neutropenia, diarrhea, and asthenia/fatigue. Incidence of on-treatment deaths among patients who received prior bortezomib and an IMiD (regardless of number of prior regimens) was similar between treatment arms. This analysis demonstrated a clear PFS benefit of 7.8 months with PAN-BTZ-Dex among patients who received >= 2 prior regimens including bortezomib and an IMiD, a population with limited treatment options and poorer prognosis.
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