Case series reveals favorable response rates with salvage VBCP chemotherapy in resistant multiple myeloma, indicating its utility when novel therapies fail.
We report our experience with vincristine, carmustine (BCNU), cyclophosphamide, and prednisone (VBCP), a regimen given in the outpatient setting to patients with multiple myeloma (MM) resistant to almost all the available novel/targeted therapies. Ten patients received salvage VBCP who were heavily pretreated with a median of 5.5 prior treatment regimens including lenalidomide, pomalidomide, bortezomib, carfilzomib, cyclophosphamide, and autologous stem cell transplantation. The objective response rate (PR) was 60%, with an additional 30% achieving stable disease (SD). The median time to progression for patients with SD was 3.6 months. The median progression free survival was 4.4 months while the median overall survival was 12.8 months. Despite severe myelosuppression being the main toxicity, 61% of the subsequent cycles were given on time. Treatment-related mortality was not observed. Our results suggest VBCP is a highly active and tolerable salvage regimen among heavily pretreated MM patients who already failed many of the novel agents.
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Am et al. (2017) studied this question.
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