Kerri Fitzgerald

DocwireNews

A study published in the Journal of Clinical Oncology assessed doublet versus triplet bortezomib-based therapy in patients with initial myeloma cast nephropathy and acute kidney injury (AKI) without the need for dialysis. The study found that triplet therapy &ldquo;did not show any benefit &hellip; on renal recovery of patients with initial cast nephrology not requiring dialysis,&rdquo; according to the authors.In this multicenter, controlled study, patients were randomized to receive bortezomib and dexamethasone with (n=92; triplet) or without (n=92; doublet) cyclophosphamide. Among patients with less than 50% reduction of serum-free light chains (sFLCs) after three cycles, chemotherapy was reinforced with either cyclophosphamide or thalidomide.Median patient age across both treatment cohorts was 68 years; serum creatinine levels were 305.5 &micro;mol/L in those receiving bortezomib and dexamethasone alone versus 273.5 &micro;mol/L in those receiving cyclophosphamide.At three months, renal response rate (primary endpoint) did not differ among those who did and did not receive cyclophosphamide (47&nbsp;vs.&nbsp;41, respectively; relative risk [RR], 0.87;&nbsp;P=0.46). Very-good partial response (defined as free light chain reduction &ge;90%) or more was achieved in 47 and 36 patients, respectively (RR, 0.76;&nbsp;P=0.10).After one cycle of chemotherapy, 69 patients in the bortezomib and dexamethasone alone group and 67 patients in the cyclophosphamide combination cohort achieved sFLC level &le;500 mg/L.&ldquo;Adding cyclophosphamide did not sufficiently improve the efficacy-toxicity balance,&rdquo; the authors wrote. Serious adverse events occurred in 30 patients in the bortezomib and dexamethasone alone cohort and 40 patients in the cyclophosphamide group. At 12 months, 19 patients had died (nine in the bortezomib and dexamethasone alone group&nbsp;vs.&nbsp;10 in the cyclophosphamide group arm); 10 deaths were related to multiple myeloma (MM) progression and three were due to infection.During a median follow-up of 27 months, 43 patients in the bortezomib and dexamethasone alone group and 42 in the cyclophosphamide group switched to a new therapy.&ldquo;Patients with MM with AKI are fragile, and indication for doublet or triplet regimen should be adapted to frailty,&rdquo; the authors concluded.

Areef Ishani, MD

Joel M. Topf, MD, FACP

Kidney Stones With Chlorthalidone Versus Hydrochlorothiazide

NKF Spring Clinical Meetings 2025

MarkAlain Déry, DO

Eric Griggs, MD

Measles in America: An Ongoing Problem

Infectious Disease

Roger Rodby, MD

Seldin Award Winner Advocates Online Education

Latest News

Does the Addition of Cyclophosphamide to Bortezomib and Dexamethasone Improve Outcomes in Patients with MM and Renal Disease?

Oncology

A study published in the Journal of Clinical Oncology assessed doublet versus triplet bortezomib-based therapy in patients with initial myeloma cast nephropathy and acute ...

Does the Addition of Cyclophosphamide to Bortezomib and Dexamethasone Improve Outcomes in Patients

About Us

Editorial Policy

Advertising

Contact Us

eNewsletters

Contribute

Career Center

MashupMD

Blood Cancers Today

Cancer Nursing Today

GU Oncology Now

Urban Health Today

Bile Duct Cancer

Colorectal Cancer

Gastroesophageal Cancer

Gastric Cancer

GEP-NETs

GIST

Liver Cancer

Pancreatic Cancer

GI Oncology Now

Anemia

Deep Vein Thrombosis

Essential Thrombocythemia

Hemophilia

Immune Thrombocytopenic Purpura

Myelodysplastic Syndromes

Myelofibrosis

Myeloproliferative Neoplasms

Polycythemia Vera

Pulmonary Embolism

Sickle Cell Disease

Thrombocytopenia

Thrombophilia

Thrombosis

Thrombotic Thrombocytopenic Purpura

Venous Thromboembolism

von Willebrand Disease

Heme Today

Acute Kidney Injury

ADPKD

Anemia and Kidney Disease

Chronic Kidney Disease

COVID-19 and Kidney Disease

Diabetes and Hypertension

End-Stage Renal Disease

Gout

Hyperkalemia

IgAN

Kidney Transplantation

Metabolic Acidosis

Nephrology Times

HER2 Breast Cancer

HR Breast Cancer

Triple-Negative Breast Cancer

Genetics & Breast Cancer

Breast Cancers Today

Atherosclerotic Disease

Atrial Fibrillation

Heart Failure

Hypertension

Interventional Cardiology

Lipid Management

Practice Tips With Dr. Lichaa

Preventive Cardiology

Stroke

Cardiology

Breast Cancer

Gynecologic Cancer

Head and Neck Cancer

Skin Cancer

Sleep

Urology

Diabetes

Ophthalmology

— Demodex Blepharitis

Neurology

Rheumatology

Gastroenterology

Pulmonology

Infectious Diseases

— HIV

Health and Wellness

Lupus

Future of Medicine

Orthopedics

Pharmacology

Career News

More

Conferences

CardioNerds

The Sleep Source With Dr. Morse

Rheumatology Rounds With Dr. Maheswaranathan

Partners

Expert Interviews

Subscribe