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).
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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.