Bortezomib, Bendamustine and Dexamethasone vs Thalidomide, Bendamustine and Dexamethasone in Myeloma patients presenting with renal failure (OPTIMAL): a randomised, multi-centre phase II trial

Journal article

Renal impairment is a serious but reversible complication of multiple myeloma (MM). Up to 20–25% of patients will have severe renal impairment at initial diagnosis, and it occurs in up to 50% of patients at some stage during their disease. It is possible to reverse renal insufficiency in approximately half of patients at diagnosis, but half will have some degree of persistent renal impairment, and of these 2–12% will require renal replacement therapy. Over the past decade, overall survival prospects for patients with MM have considerably improved but less so for MM patients complicated by renal impairment. Recipients of dialysis and a diagnosis of MM have median overall survival of 2–3 years even in the novel agent induction era. This is mainly because of a high early death rate, with 28% of newly diagnosed myeloma patients in myeloma trials with renal failure not surviving beyond 100 days compared with 10% overall. Outcomes in patient’s presenting with raised serum free light chain levels (sFLC) and renal impairment correlate with the speed of reduction in sFLC. The MERIT trial, showed patients who were alive and dialysis free at 100 days (as compared to those dead or on dialysis) had lower levels of FLC at entry and greater reductions in sFLC in the first two weeks

Authors: Ramasamy, K; Iqbal, G; Brouwer, R; Stalker, V; Akhtar, S

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Springer Nature [academic journals on nature.com]
• Journal: Blood Cancer Journal
• Volume: 12
• Issue: 11
• Pages: 162-162
• Article number: 162
• Publication date: 2022-11-29
• DOI: 10.1038/s41408-022-00758-7
• EISSN: 2044-5385
• ISSN: 2044-5385
• Language: English
• Keywords: Lenalidomide; Medicine; Dexamethasone; Thalidomide; Lymphoma; Rituximab; Pharmacology; Internal medicine; Multiple myeloma; Bortezomib; Bendamustine; Oncology