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A randomized multicentric study comparing alternating combination chemotherapy (VCMP/VBAP) and melphalan-prednisone
J Bladé1, J San Miguel, A Alcalá
1PETHEMA: Spanish Cooperative Group for Hematological Malignancies Treatment, Hospital Clínico y Provincial, Barcelona, Spain.
Blut
|June 1, 1990
Summary
Combination chemotherapy showed higher objective response rates in multiple myeloma patients compared to MP. While overall survival data is pending, VCMP/VBAP therapy suggests a potential survival benefit over MP treatment.
Area of Science:
- Hematology
- Oncology
- Clinical Trials
Background:
- Multiple myeloma is a hematologic malignancy.
- Established treatment regimens include MP (melphalan and prednisone).
- Novel combination chemotherapy regimens are being investigated.
Purpose of the Study:
- To compare the efficacy of MP chemotherapy versus alternating cycles of VCMP (vincristine, cyclophosphamide, melphalan, and prednisone) and VBAP (vincristine, carmustine, doxorubicin, and prednisone) in multiple myeloma.
- To evaluate objective response rates and survival outcomes.
Main Methods:
- Randomized clinical trial involving 386 multiple myeloma patients.
- Treatment arms: MP chemotherapy versus alternating VCMP/VBAP combination chemotherapy.
- Data collected on prognostic parameters, objective responses, and survival.
Main Results:
- No significant differences in major prognostic parameters between groups.
- Combination chemotherapy (VCMP/VBAP) demonstrated a significantly higher objective response rate (47.8%) compared to MP (32.2%, P = 0.01).
- Median survival for all patients was 33.5 months; however, median survival for MP was 26.8 months, while VCMP/VBAP median survival was not yet reached.
Conclusions:
- Combination chemotherapy with alternating VCMP/VBAP cycles appears more effective in achieving objective responses in multiple myeloma.
- Preliminary survival data suggests a potential benefit for the VCMP/VBAP regimen, though longer follow-up is required for definitive conclusions.
- Further analysis is necessary with complete patient data and extended follow-up to confirm survival differences.