Tumori Journal Abstract Book - October 2020 - 166

166	
Conclusions: The improving of PFS but not of OS is probably due to: -lack of biomarkers to select patients to treat
with anti -VEGF; -"imaging bias" due to a pseudoresponse of bevacizumab versus a pseudo-progression of
radio-chemotherapy treatment; -"phenotypic switching" to
more aggressive forms after anti-VEGF therapy. The
results of this metanalysis are in line with literature: the
addition of bevacizumab to chemotherapy in the recurrent
GBM shows an increasing of PFS more than bevacizumab
alone, without any benefit on OS.

R - Lymphomas and Myeloma
R01
BENDAMUSTINE-BORTEZOMIBDEXAMETHASONE (BVD) IN HEAVILY
PRETREATED MULTIPLE MYELOMA: OLD/
NEW IN NOVEL AGENTS' ERA
Cerchione C.1, Catalano L.2, Nappi D.2, Rocco S.3, Palmieri S.3,
Pareto A.E.2, Musuraca G.4, Pane F.2, Ferrara F.3, Martinelli G.4
1
Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC); 2Hematology - AOU Federico II, Napoli; 3Hematology
- AORN Cardarelli, Napoli; 4Hematology - Istituto Scientifico Romagnolo per
lo Studio e la Cura dei Tumori (IRST) - IRCCS, Napoli

Background: Bendamustine is an old bi-functional alkylating agent which has proved to be effective in relapsed,
refractory and in new diagnosed Multiple Myeloma (MM).
Thus, aiming to provide further insights in this field, also in
novel agents'era, we present here a retrospective, real-life
analysis of patients with relapsed/refractory MM (rrMM),
who had received salvage therapy with bendamustine in
combination with bortezomib and dexamethasone (BVD).
Matherial and methods: 81 patients (44 M/37 F), with
rrMM, median age at diagnosis 59.4 years (r. 36-82), median
age at start of treatment 63.6 years (r.37-86) treated with
several lines of treatments (median 6, r. 2-11), every refractory to all the drugs previously received (also Bortezomib),
received BVD (B 90 mg/sqm days 1,2; V 1.3 mg/sqm days
1,4,8,11, D 20 mg days 1,2,4,5,8,9,11,12, Pegfilgrastim day
+4) every 28 days, until progression. All patients had previously received bortezomib-based and IMIDs-based treatments, and 32% (26/81) had also received radiotherapy.
69% (56/81) had undergone single or double autologous and
three (2%) allogeneic stem cell transplant. All patients were
relapsed and refractory to last therapies.
Results: Bendamustine was well tolerated, with grade 3-4
transfusion-dependent anemia in 56% (46/81) of patients,
and 43% (35/81) grade 3-4 neutropenia (no ospedalization
was required, no septic shocks were observed). No severe
extrahematologic toxicity was observed, only grade 1 gastrointestinal side effect (nausea), treated by common antiemetic
drugs. According to IMWG, ORR was 63% (51/81: 7 CR, 18
VGPR, 15 PR, 11 MR) with 11 PD and 19 patients in SD,
which can be considered as an impressive result in this

Tumori Journal 106(2S)
subset of patients. In particular, for 11 patients, BVD was,
after having achieved at least a PR, a bridge to second auSCT,
and for two patients a bridge to alloSCT. Eight patients have
surprisingly achieved a notable PR after failure of novel
agents (i.e. Carfilzomib, Daratumumab and Pomalidomide).
Median time to response was 1.3 months (r.1-3), median OS
from diagnosis was 67.3 months (r.6-151), median OS from
start of Bendamustine was 9.6 months (r.2-36).
Conclusions: The triplet BVD has shown significant efficacy in a particularly severe setting of patients, relapsed
and refractory to all available therapeutic resources, and,
in particular cases, it could be considered as a bridge to a
second autologous or allogenic SCT, also after failure of
novel agents.

R02
CARFILZOMIB-LENALIDOMIDEDEXAMETHASONE IN THE
MANAGEMENT OF LENALIDOMIDEREFRACTORY MULTIPLE MYELOMA
Nappi D.1, Catalano L.2, Pareto A.E.2, Musuraca G.3, Pane F.2,
Martinelli G.3, Cerchione C.3
1
Department of Hematology & CBMT, Ospedale di Bolzano, Bolzano; 2AOU
Federico II, Napoli; 3Hematology - Istituto Scientifico Romagnolo per lo Studio
e la Cura dei Tumori (IRST) - IRCCS, Meldola (FC)

Background: In this retrospective observational trial, it
has been evaluated efficacy and safety of carfilzomib,
epoxyketone proteasome inhibitor of second generation, in
combination with lenalidomide-dexamethasone (KRD) as
salvage regimen in patients with rrMM, refractory to lenalidomide, where lenalidomide-based regimens have no
proven efficacy.
Material and methods: 41 patients (23 M/18 F), with
rrMM, median age at diagnosis 63.7 years (r. 43-82), median
age at start of treatment 67 years (r. 48-84) previously treated
with several lines of treatments (median 3, r. 2-11), underwent to KRD regimen (ASPIRE trial schedule) for a median
treatment cycles of 8 (r 2-18). ISS was equally distributed,
and all patients had previously been treated with bortezomib
and IMIDs, and were refractory to this agents. 61% (19/31)
of them had undergone at least to a single ASCT.
Results: According to IMWG criteria, after a median follow-up of 9 months (r. 2-18), ORR was 68,2% (28/41: 9 CR,
12 VGPR, 7 PR) with 5 progressive diseases (PD) and 8
patients in stable disease (SD): this can be considered as an
impressive result in this subset of rrMM patients, refractory
to lenalidomide. In particular, for 11 patients, KRD was,
after having achieved at least a PR, a bridge to second/third
autologous SCT. Median time to response was 1.3 months
(r.1-4), median OS from diagnosis was 62 months (r. 9-170),
median OS from start of Carfilzomib was 11 months (r.
2-18). Carfilzomib was well tolerated, with grade 2 anemia
in 39%(16/41) of patients, successfully managed by ESAs,



Tumori Journal Abstract Book - October 2020

Table of Contents for the Digital Edition of Tumori Journal Abstract Book - October 2020

Contents
Tumori Journal Abstract Book - October 2020 - Cover1
Tumori Journal Abstract Book - October 2020 - Cover2
Tumori Journal Abstract Book - October 2020 - I
Tumori Journal Abstract Book - October 2020 - II
Tumori Journal Abstract Book - October 2020 - Contents
Tumori Journal Abstract Book - October 2020 - IV
Tumori Journal Abstract Book - October 2020 - V
Tumori Journal Abstract Book - October 2020 - 1
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