Mosaad M El Gammal1*, Mohamed A Samra1, Noha H Ibrahim2 and Maha A Abdel Fatah3
1Department of Medical Oncology, National Cancer Institute Egypt, Egypt
2Department of Clinical and Chemical Pathology, National Cancer Institute Egypt, Egypt
3Department of Clinical Oncology, El Fayoum Faculty of Medicine, Egypt
Introduction: In the era of novel anti-myeloma agents and monoclonal antibodies (daratumumab) and due to their high cost, earlier low cost regimens (VAD or CyBorD) may be used.
Objective: to compare outcome of treatment of CyBorD versus VAD regimens in multiple myeloma.
Methods: This cohort study included 89 MM patients treated at National Cancer Institute (NCI), Cairo, Egypt from January 2011 to December 2015. All patients were evaluated clinically and laboratory for different responses with either lines of treatment (VAD vs. CyBorD), and correlated with different survival parameters; Progression Free Survival (PFS), Disease Free (DFS), and Overall Survival (OS), and clinico-pathologic factors.
Results: The median age of patients was 54 years (32-76), with male predominance (male to female ratio 1.87:1). The most common presenting symptoms were bony pains (44.9%) followed by bony masses (22.5%), fractures (16.9%), pallor (7.9%), neurological symptoms (5.6%) and finally oliguria (2.2%). CyBorD have better overall response rate (≥ PR) (p=0.031), PFS (p=0.004) and DFS (p=0.013) as 1st line treatment compared to VAD regimen. Also in previously treated patients CyBorD showed better PFS (p=0.039) compared to VAD regimen. There was a significant relation between age (p=0.001 & <0.001) and ASCT (p=0.001 & 0.034) with PFS and OS respectively.
Conclusion: CyBorD have significant better overall response treatment (≥ PR), PFS and DFS in 1st line treatment compared to VAD regimen. While in previously treated patients only PFS benefit for CyBorD over VAD regimen was obtained. Age and ASCT had significant effect on PFS and OS.
Multiple myeloma; CyBorD; VAD regimen
El Gammal MM, Samra MA, Ibrahim NH, Abdel Fatah MA. Superiority of CyBorD Over VAD is More Evident in First than in Second Line Treatment of Multiple Myeloma. Ann Blood Cancer. 2019;2(1):1008.