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10.1111/bjh.13296

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suck abstract from ncbi


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pmid25683772
      Br+J+Haematol 2015 ; 169 (2 ): 219-27
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  • Phase Ib/II trial of CYKLONE (cyclophosphamide, carfilzomib, thalidomide and dexamethasone) for newly diagnosed myeloma #MMPMID25683772
  • Mikhael JR ; Reeder CB ; Libby EN ; Costa LJ ; Bergsagel PL ; Buadi F ; Mayo A ; Nagi Reddy SK ; Gano K ; Dueck AC ; Stewart AK
  • Br J Haematol 2015[Apr]; 169 (2 ): 219-27 PMID25683772 show ga
  • Sixty-four transplant-eligible patients with newly diagnosed multiple myeloma (NDMM) received carfilzomib (days 1, 2, 8, 9, 15, 16), 300 mg/m(2) cyclophosphamide (days 1, 8, 15), 100 mg thalidomide (days 1-28) and 40 mg dexamethasone (days 1, 8, 15, 22) in 28-day cycles (CYKLONE regimen). Carfilzomib was dose-escalated to 15/20, 20/27, 20/36 and 20/45 mg/m(2) to determine the maximum tolerated dose (MTD), which was 20/36 mg/m(2) . Regardless of attribution, common Grade 3 or higher adverse events were lymphopenia (38%), neutropenia (23%) and anaemia (20%). All peripheral neuropathy (31%) was Grade 1 and considered most likely to be thalidomide-related. Common cardiac or pulmonary events of any grade in ?5% of patients included dyspnoea (20%) and cough (6%). Overall (N = 64), 91% of patients achieved a best response of partial response or better across all cycles of treatment, including five patients with complete responses. At the MTD (n = 29), 59% of patients achieved a very good partial response or better after four cycles (primary end point). Stem cell collection was successful in all patients in whom it was attempted (n = 42). Progression-free survival and overall survival at 24 months was 76% and 96%, respectively (median follow-up of 17·5 months). CYKLONE appears highly efficacious in NDMM patients, with manageable toxicities.
  • |Adult [MESH]
  • |Aged [MESH]
  • |Aged, 80 and over [MESH]
  • |Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use [MESH]
  • |Cyclophosphamide/administration & dosage [MESH]
  • |Dexamethasone/administration & dosage [MESH]
  • |Drug Administration Schedule [MESH]
  • |Female [MESH]
  • |Follow-Up Studies [MESH]
  • |Humans [MESH]
  • |Male [MESH]
  • |Maximum Tolerated Dose [MESH]
  • |Middle Aged [MESH]
  • |Multiple Myeloma/diagnosis/*drug therapy/mortality [MESH]
  • |Neoplasm Staging [MESH]
  • |Oligopeptides/administration & dosage [MESH]
  • |Thalidomide/administration & dosage [MESH]


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