D(T)PACE as salvage therapy for aggressive or refractory multiple myeloma

Area of Science:

• Hematology
• Oncology
• Clinical Pharmacology

Background:

• Dexamethasone ± thalidomide with cisplatin, doxorubicin, cyclophosphamide, and etoposide (D(T)PACE) is a salvage chemotherapy regimen.
• Its efficacy and durability in relapsed/refractory multiple myeloma (MM) or plasma cell leukaemia (PCL) are not well-established.

Purpose of the Study:

• To evaluate the efficacy and durability of the D(T)PACE regimen in heavily pretreated patients with relapsed/refractory multiple myeloma.

Main Methods:

• Retrospective analysis of 75 patients with relapsed/refractory MM treated with D(T)PACE at two tertiary care centers.
• Data collected included patient characteristics, prior treatments, response rates, progression-free survival (PFS), and overall survival (OS).

Main Results:

• The overall response rate (ORR) was 49%, with a median PFS of 5.5 months and OS of 14.0 months.
• Patients who proceeded to autologous stem cell transplant (ASCT) or clinical trial had improved outcomes (median PFS 13.4 months, OS 20.5 months).
• The regimen was effective in patients with PCL and leptomeningeal disease.

Conclusions:

• D(T)PACE is an effective salvage therapy for heavily pretreated MM patients, offering a reasonable response rate.
• The short PFS suggests its primary role is as a bridge to definitive therapy, such as ASCT.