Alternating Combination Chemotherapy COP (Cyclophosphamide, Vincristine, Prednisone) and MP (Melphalan, Prednisone) in Multiple Myeloma: a Multicenter Phase II Study (JCOG8906)

Takenaka, T; Shirakawa, S; Mikuni, Chikara; Sai, Toshiaki; Shimamoto, Yoshinori; Araki, Koichi; Hirano, Masami; Miura, Akira B.; Ohno, Y; Ichimaru, Michito; Hanada, Shuichi; Inaba, Satoshi; Kojima, Hiroshi; Toki, H; Tajima, Kinuko; Niimi, Miyuki; Fukuda, Haruhiko; Shimoyama, Masanori

doi:10.1093/jjco/29.10.485

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…We obtained informed consent from the patient to target both FL and MM therapeutically. The treatment by chemotherapy was initiated with three cycles of rituximab (RTX) + cyclophosphamide, vincristine, prednisone (COP)/melphalan, prednisone (MP) 12 (vincristine + cyclophosphamide [days 1, 8, and 15] + melphalan [days 29–31], + prednisolone [days 1–3, 8–10, 15–17, and 29–31]), followed by three cycles of RTX + bendamustine. RTX was then administered twice as a single agent.…”

Section: Case Reportmentioning

confidence: 99%

Coexistence of primary colorectal follicular lymphoma and multiple myeloma: a case report

Saito¹,

Miyashita²,

Miura³

et al. 2018

IJGM

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Colorectal follicular lymphoma (FL) occurs less frequently than duodenal-type FL, which is an established entity, and primary multiple FL only involving the colon is rare. Furthermore, the coexistence of lymphoma and multiple myeloma (MM) within the same patient is rare and the current study reports such a case. The patient was an asymptomatic 62-year-old man. He underwent colonoscopy screening, which revealed at least five polypoid tumors from the cecum to the rectum. Biopsy samples stained positive for CD20 and B-cell lymphoma 2 (BCL2) but stained negative for CD10, and fluorescence in situ hybridization analysis identified IGH/BCL2 in 95.2% of the tumor cells. Based on these findings, the patient was diagnosed with FL. On the bone marrow aspirate, the plasma cell count was 30% of all nucleated cells. Bence-Jones κ-type protein was detected by protein electrophoresis in serum and urine. The serum-free light chain κ/λ level was significantly elevated (484.3). Thus, the patient was also diagnosed with MM. Both FL and MM were targeted therapeutically; rituximab and bendamustine were effective for FL, and lenalidomide and low-dose dexamethasone were effective for MM. The patient was treated for 3 years and 7 months and, until now, was off-treatment for 4 years without rapid progression of the two malignancies. Although both diseases are still present, the patient has maintained stable disease. Our findings suggest that lymphoma and MM should be targeted separately as independent hematological malignancies when they occur concurrently.

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Section: Case Reportmentioning

confidence: 99%

Coexistence of primary colorectal follicular lymphoma and multiple myeloma: a case report

Saito¹,

Miyashita²,

Miura³

et al. 2018

IJGM

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“…Alkylators and steroids have been the key drugs for remission induction, but MST was around 3 years without a plateau in the survival curve (47). A Phase II study of COP (cyclophosphamide, prednisolone) -MP (melphalan, prednisolone) for untreated overt MM patients (JCOG8906) revealed a similar efficacy to those from the USA and Europe (48). A subsequent randomized Phase III study comparing modified (m)COP-MP with/without ranimustine for untreated overt MM (JCOG9301) revealed that addition of ranimustine to mCOP/ MP has no benefit for survival, despite improving the response rate and PFS, similar to findings of other studies evaluating the addition of new agents to alkylators and steroids in MM (49).…”

Section: Multiple Myelomamentioning

confidence: 99%

Lymphoma Study Group of JCOG

Tsukasaki

Tobinai²,

Hotta

et al. 2011

Japanese Journal of Clinical Oncology

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Phase III Study of Ranimustine, Cyclophosphamide, Vincristine, Melphalan, and Prednisolone (MCNU-COP/MP) versus Modified COP/MP in Multiple Myeloma: A Japan Clinical Oncology Group Study, JCOG 9301

Takenaka

Itoh

Suzuki

et al. 2004

International Journal of Hematology

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To investigate whether combination chemotherapy with vincristine, cyclophosphamide, prednisolone, and melphalan (COP/ MP) with the addition of ranimustine (MCNU) (MCNU-COP/MP) is superior to the slightly modified COP/MP (mCOP/MP) regimen in multiple myeloma (MM), a multicenter randomized study was performed. Two hundred ten patients with newly diagnosed, overt MM not treated with chemotherapy were enrolled from 32 institutions of the Lymphoma Study Group of the Japan Clinical Oncology Group and were randomized to receive either MCNU-COP/MP or mCOP/MP. The response rate (RR) to mCOP/MP was 43.7% (95% confidence interval [CI], 33.9%-53.8%] and to MCNU-COP/MP was 56.1% (95% CI, 46.1%-65.7%) (P = .097). The progression-free survival (PFS) was significantly longer for patients treated with MCNU-COP/MP than for patients treated with mCOP/MP (median, 23.0 months [95% CI, 18.9-25.8] versus 15.8 months [95% CI, 14.1-19.4]) (P = .014). However, no significant difference in overall survival rate (OS) was observed between the groups (median, 49.9 months [95% CI, 40.4-59.1] versus 44.0 months [95%, CI, 32.8-59.8]) (P = .75). Grades 3 and 4 hematological toxicities were more frequently observed with MCNU-COP/MP than with mCOP/MP, but the incidence of grades 3 and 4 nonhematological toxicities was low in both groups. In conclusion, MCNU-COP/MP in comparison with mCOP/MP improved RR and PFS in overt MM; however, this outcome did not contribute to prolonging OS, indicating that addition of MCNU to mCOP/MP has no benefit on survival.

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Alternating Combination Chemotherapy COP (Cyclophosphamide, Vincristine, Prednisone) and MP (Melphalan, Prednisone) in Multiple Myeloma: a Multicenter Phase II Study (JCOG8906)

Abstract: The COP-MP regimen for overt MM is thought to be one of the effective CCTs according to the results of the present phase II study.

Cited by 3 publications

References 23 publications

Coexistence of primary colorectal follicular lymphoma and multiple myeloma: a case report

Coexistence of primary colorectal follicular lymphoma and multiple myeloma: a case report

Lymphoma Study Group of JCOG

Phase III Study of Ranimustine, Cyclophosphamide, Vincristine, Melphalan, and Prednisolone (MCNU-COP/MP) versus Modified COP/MP in Multiple Myeloma: A Japan Clinical Oncology Group Study, JCOG 9301

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