Bortezomib, Dexamethasone Seems Preferred for Transplant-Ineligible Myeloma

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Bortezomib-based regimens used in transplantation-ineligible patients with multiple myeloma have shown to produce good outcomes.
Bortezomib-based regimens used in transplantation-ineligible patients with multiple myeloma have shown to produce good outcomes.

Bortezomib-based regimens used in transplantation-ineligible patients with multiple myeloma have shown to produce good outcomes in U.S. community practice, according to a recent study published online this week in the Journal of Clinical Oncology

In the U.S. community-based, three-arm phase IIIB, UPFRONT trial, researchers randomly assigned 502 patients to receive 24 weeks of induction therapy with bortezomib-dexamethasone (VD; n=168), bortezomib-thalidomide-dexamethasone (VTD; n=167), or bortezomib-melphalan-prednisone (VMP; n=167). Subsequently, all three groups received additional 25 weeks of bortezomib maintenance therapy.

The primary endpoint was progression-free survival (PFS), with  overall survival (OS) and overall response rate as the secondary endpoints. 

After median follow-up of 42.7 months, there were no significant differences in PFS (P=0.46) or OS (P=0.79) among VD (PFS=14.7 months; OS=49.8 months), VTD (PFS=15.4 months; OS=51.5 months), and VMP-treated patients (PFS=17.3 months; OS=53.1 months).

RELATED: Bortezomib Consolidation More Effective Than Observation for Newly Diagnosed Multiple Myeloma

VTD had more adverse events compared with VD or VMP, and the overall response rate for VD, VTD, and VMP was 73%, 80%, and 70%, respectively. Moreover, bortezomib maintenance therapy did not produce cumulative toxicity. 

The findings suggest that Bortezomib-based regimens in transplantation-ineligible patients with multiple myeloma produced good outcomes with no particular regimen being better than the other.  

Reference

  1. Niesvizky R, Flinn IW, Rifkin R, et al. Community-based phase IIIB trial of three UPFRONT bortezomib-based myeloma regimens. J Clin Oncol. 2015. [Epub ahead of print]. doi: 10.1200/JCO.2014.58.7618.

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