Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Gemcitabine in Treating Patients with Refractory or Relapsed Multiple Myeloma

  • Zheng, Hua (Department of Orthopedics, Yongchuan Hospital, Chongqing Medical University) ;
  • Yang, Fan (Department of Orthopedics, Yongchuan Hospital, Chongqing Medical University)
  • Published : 2014.11.28
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Patients with refractory or relapsed multiple myeloma are considered to have a very poor prognosis, and new regimens are needed to improve the outcome. Gemcitabine, a nucleoside antimetabolite, is an analog of deoxycytidine which mainly inhibits DNA synthesis through interfering with DNA chain elongation and depleting deoxynucleotide stores, resulting in gemcitabine-induced cell death. Here we performed a systemic analysis to evaluate gemcitabine based chemotherapy as salvage treatment for patients with refractory and relapsed multiple myeloma. Methods: Clinical studies evaluating the impact of gemcitabine based regimens on response and safety for patients with refractory and relapsed multiple myeloma were identified by using a predefined search strategy. Pooled response rate (RR) of treatment were calculated. Results: In gemcitabine based regimens, 3 clinical studies which including 57 patients with refractory and relapsed multiple myeloma were considered eligible for inclusion. Systemic analysis suggested that, in all patients, pooled RR was 15.7% (9/57) in gemcitabine based regimens. Major adverse effects were hematologic toxicity, including grade 3 or 4 anemia, leucopenia and thrombocytopenia i. No treatment related death occurred with gemcitabine based treatment. Conclusion: This systemic analysis suggests that gemcitabine based regimens are associated with mild activity with good tolerability in treating patients with refractory or relapsed multiple myeloma.

Keywords

References

  1. Attal M, Harousseau JL, Stoppa AM, et al (1995). Highdose chemotherapy in multiple myeloma: a prospective randomized study of the "Intergroupe Francais du Myelome" (IFM). Vth International Workshop on Multiple Myeloma 1995, La Baule, France.
  2. Barlogie B, Smith L, Alexanian R (1984). Effective treatment of advanced multiple myeloma refractory to alkylating agents. N Engl J Med, 310, 1353-6. https://doi.org/10.1056/NEJM198405243102104
  3. Fernand JP, Levy Y, Gerota J, et al (1989). Treatment of aggressive multiple myeloma by high-dose chemotherapy and total body irradiation followed by blood stem cells autologous graft. Blood, 73, 20-3.
  4. Bjorkstrand B (1995). 474 autotransplants in multiple myeloma-results of the EBMT. Vth International Workshop on Multiple Myeloma 1995; September 10-13: La Baule, France.
  5. Braakhuis BJ, van Dongen GA, Vermorken JB, et al (1991). Preclinical in vivo activity of 2', 2'-difluorodeoxycytidine (gemcitabine) against human head and neck cancer. Cancer Res, 51, 211-4.
  6. Gazitt Y1, Shaughnessy P, Rothenberg ML, et al (2006). A phase II trial with gemcitabine and paclitaxel for the treatment of refractory and relapsed multiple myeloma patients. Oncol Rep, 16, 877-84.
  7. Gay F, Larocca A, Wijermans P, et al (2011). Complete response correlates with long-term progression-free and overall survival in elderly myeloma treated with novel agents: Analysis of 1175 patients. Blood, 117, 3025-31. https://doi.org/10.1182/blood-2010-09-307645
  8. Kumar SK, Rajkumar SV, Dispenzieri A, et al (2008). Improved survival in multiple myeloma and the impact of novel therapies. Blood, 111, 2516-20. https://doi.org/10.1182/blood-2007-10-116129
  9. Kyle RA, Child JA, Anderson K, et al (2003). Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: a report of the International Myeloma Working Group. Br J Haematol, 121, 749-57. https://doi.org/10.1046/j.1365-2141.2003.04355.x
  10. Lilenbaum RC, Green MR (1993). Novel chemotherapeutic agents in the treatment of non-small-cell lung cancer. J Clin Oncol, 11, 1391-402.
  11. Moore DF Jr, Pazdur R, Daugherty K et al (1992). Phase II study of gemcitabine in advanced colorectal adenocarcinoma. Invest New Drugs, 10, 323-5. https://doi.org/10.1007/BF00944189
  12. Offidani M, Mele A, Corvatta L, Marconi M et al (2002). Gemcitabine alone or combined with cisplatin in relapsed or refractory multiple myeloma. Leuk Lymphoma, 43, 1273-9. https://doi.org/10.1080/10428190290026330
  13. Palumbo A, Anderson K (2011). Multiple myeloma. New Engl J Med, 364, 1046-60. https://doi.org/10.1056/NEJMra1011442
  14. Sun TT, Wang JL, Fang JY (2013). Gemcitabine alone or in combination with cisplatin for advanced biliary tract carcinomas: an overview of clinical evidence. Asian Pac J Cancer Prev, 14, 877-83. https://doi.org/10.7314/APJCP.2013.14.2.877
  15. Su A, Zhang J, Pan ZH, et al (2013). Salvage therapy of gemcitabine plus endostar significantly improves progression-free survival (PFS) with platinum-resistant recurrent epithelial ovarian cancer. Asian Pac J Cancer Prev, 14, 1841-6. https://doi.org/10.7314/APJCP.2013.14.3.1841
  16. Wang M, Gu J, Wang HX, et al (2012). Retrospective study of gemcitabine based chemotherapy for unresectable or recurrent esophagus squamous cell carcinoma refractory to first line chemotherapy. Asian Pac J Cancer Prev, 13, 4153-6. https://doi.org/10.7314/APJCP.2012.13.8.4153
  17. Wei MY, Zhuang YF, Wang WM (2014). Gemcitabine for the treatment of patients with osteosarcoma. Asian Pac J Cancer Prev, 15, 7159-62. https://doi.org/10.7314/APJCP.2014.15.17.7159
  18. Weick JK1, Crowley JJ, Hussein MA, et al (2002). The evaluation of gemcitabine in resistant or relapsing multiple myeloma, phase II: a Southwest Oncology Group study. Invest New Drug, 20, 117-21. https://doi.org/10.1023/A:1014493007347
  19. Yuan SF, Zhang LP, Zhu LJ, et al (2013). Phase II clinical study on the GEMOX regimen as second- line therapy for advanced ovarian cancer. Asian Pac J Cancer Prev, 14, 3949-53. https://doi.org/10.7314/APJCP.2013.14.6.3949

Cited by

  1. Pooled Analysis of Pomalidomide for Treating Patients with Multiple Myeloma vol.16, pp.8, 2015, https://doi.org/10.7314/APJCP.2015.16.8.3163