lunes, 21 de agosto de 2017

Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ®)—Health Professional Version - National Cancer Institute

Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ®)—Health Professional Version - National Cancer Institute

National Cancer Institute

Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ®)–Health Professional Version


Changes to This Summary (08/10/2017)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Added Royer et al. as reference 19.
Revised text to state that newer clinical investigations are stratifying patients with multiple myeloma into so-called good-risk, intermediate-risk, and high-risk groups, based on genetic aberrations detected by interphase fluorescence in situ hybridization (cited Sonneveld et al. as reference 5.)
Revised cytogenetic findings for high-risk multiple myeloma in Table 3.
Added text about a prospective, randomized clinical trial that investigated the role of immediate therapy for patients with smoldering multiple myeloma by specifying high-risk patients with both 10% or more marrow plasma cells and a serum monoclonal (or myeloma) protein (M protein) of at least 3 g/dL. The trial randomly assigned 125 patients to receive lenalidomide plus dexamethasone or observation; at a median follow-up of 75 months, lenalidomide plus dexamethasone provided benefit in time to progression compared with observation; however, there was no difference in overall survival (OS) (cited Mateos et al. as reference 6 and level of evidence 1iiDiii).
Added Sanchorawala et al. as reference 10.
Added text to state that achievement of minimal residual disease after induction therapy (with or without consolidation therapy) is associated with improved OS; and that while this interim marker may be useful for the design of clinical trials, there are no data suggesting that this interim marker improves outcomes by altering subsequent therapy (added Munshi et al. as reference 11 and Gormley et al. as reference 12).
Revised text to update 46-month follow-up data for a prospective, randomized study of 1,623 transplant-ineligible, untreated patients that compared lenalidomide and low-dose dexamethasone (when given until progression) with a 72-week induction regimen with melphalan plus prednisone plus thalidomide (cited Hulin et al. as reference 28 and level of evidence 1iiA).
Extensively revised the subsection on daratumumab.
Added text to state that elotuzumab is a monoclonal antibody directed at SLAMF7 (single-lymphocyte activating molecular F7) that is now U.S. Food and Drug Administration approved for use in combination therapy after failure of one previous regimen.
Added pomalidomide/cyclophosphamide/dexamethasone as a new combination regimen(cited Baz et al. as reference 104).
Added Gay et al. as reference 120.
Added text about a clinical trial of zoledronate given once a month compared with zoledronate given every 12 weeks that showed noninferiority for the 12-week regimen in 1,822 patients with bone metastases from breast cancer, prostate cancer, or multiple myeloma; however, this study included only 278 myeloma patients, and evaluation of this subgroup was insufficiently powered to establish noninferiority for the 12-week regimen (cited Himelstein et al. as reference 164).
Added Ali et al. as reference 4.
This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.
  • Updated: August 10, 2017

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